Comparison of Postoperative Pain After the Utilization of Different File Systems in Single Visit Endodontics

Anuj Bhardwaj,1,2 Rudra Kumar Gupta,1 Ayfer Atav Ates,3 Dian Agustin Wahjuningrum,2 Burçin Arıcan,4 Taher AlOmari,5 Alexander Maniangat Luke,6,7 Ajinkya M Pawar2,8 1Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, India; 2Department of Conservative Dentistry, Universitas Airlangga, Surabaya, Indonesia; 3Department of Endodontics, Istinye University, Faculty of Dentistry, Istanbul, Turkey; 4Department of Endodontics, Bahçeşehir University, School of Dental Medicine, Istanbul, Turkey; 5Department of Conservative Dentistry, Jordan University of Science and Technology, Al-Ramtha, Jordan; 6Department of Clinical Science, College of Dentistry, Ajman University, Ajman, United Arab Emirates; 7Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates; 8Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, 400008, IndiaCorrespondence: Dian Agustin Wahjuningrum, Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia, Email dian-agustin-w@fkg.unair.ac.id Alexander Maniangat Luke, Department of Clinical Science, College of Dentistry, Ajman University, J1 Building C Block, Al-Jurf 346, Ajman, United Arab Emirates, Email a.luke@ajman.ac.aePurpose: This prospective single-blind, parallel-group, randomized clinical trial was aimed to compare the effect of three different rotary instrumentation systems ProTaper Next (PTN), Self-Adjusting File (SAF) and XP-endo Shaper (XPS) on postoperative pain and analgesic intakes.Patients and Methods: A total of 159 molars diagnosed with symptomatic irreversible pulpitis were randomly divided into three study groups according to the instrumentation techniques: PTN (n = 54), SAF (n = 52), and XPS (n = 53). The preoperative pain scores were taken before the onset of treatment in the groups. After a single appointment for root canal treatment, the patients were asked to rate the level of their pain according to the Visual Analog Scale (VAS) of 100 mm at 6, 24, 48, and 72-hour post-treatment intervals. Ibuprofen was prescribed to be taken while experiencing pain; patients were requested to note the number of pills consumed at intervals after treatment.Results: The patients in SAF and XPS groups had lower mean VAS scores than the PTN group at 24-, 48-, and 72-hour intervals (p < 0.05). The most common analgesic intake was optimally seen in the PTN group at a 6-hour interval. All shaping procedures caused postoperative pain, whose intensity decreased with time.Conclusion: The SAF and XPS groups had a lesser intensity of pain as well as minimum analgesic intakes as compared to the PTN group. All instrumentation systems moderately caused pain, and the PTN group experienced the highest pain among others.Keywords: postoperative pain, ProTaper next, randomized clinical trial, root canal treatment, XP-endo shaper, patient satisfaction