Endodontic Disease, Obturation, Postoperative Pain
Conditions
Keywords
Postoperative Pain, Bioceramic, Root canal filling
Brief summary
As part of root canal treatment, canals should be sealed to prevent further contaminations. There are multiple accepted techniques to fill-obturate canals. In the past, different obturation techniques have been compared. The most current technique used, a single cone with bioceramic sealer, has not been compared. This clinical investigation will compare the postoperative pain of this technique to another common technique used in our clinic. Postoperative pain after one-visit root-canal treatment on teeth with vital pulps: Comparison of three different obturation techniques.
Interventions
PROCEDURENon-surgical root canal treatment filled with WVT
All eligible teeth were isolated with a rubber dam during root canal treatment. The procedures were performed under a microscope (OPMI Pico; Carl Zeiss, Gottingen, Germany). After access, location of canals, and determination of working length (WL) with Root ZX II apex locator (J Morita, Kyoto, Japan), the canals were instrumented using various .04 taper rotary NiTi instruments to a minimum apical size of 35. 4% Sodium hypochlorite was used as the main irrigant with a 31-gauge needle. 17% EDTA was used as the final irrigant. Passive ultrasonic irrigation with size 20 Acteon tip inserted 2mm short of WL was performed with both 4% sodium hypochlorite and 17% EDTA for 10 seconds in each canal. After final irrigation, the canals were dried with paper points. The master gutta-percha cone fit was verified with periapical radiographs before filling the tooth. WVT was used to fill the tooth when the months were January, March, May, July, September, and November.
PROCEDURENon-surgical root canal treatment filled with SBT
All eligible teeth were isolated with a rubber dam during root canal treatment. The procedures were performed under a microscope (OPMI Pico; Carl Zeiss, Gottingen, Germany). After access, location of canals, and determination of working length (WL) with Root ZX II apex locator (J Morita, Kyoto, Japan), the canals were instrumented using various .04 taper rotary NiTi instruments to a minimum apical size of 35. 4% Sodium hypochlorite was used as the main irrigant with a 31-gauge needle. 17% EDTA was used as the final irrigant. Passive ultrasonic irrigation with size 20 Acteon tip inserted 2mm short of WL was performed with both 4% sodium hypochlorite and 17% EDTA for 10 seconds in each canal. After final irrigation, the canals were dried with paper points. The master gutta-percha cone fit was verified with periapical radiographs before filling the tooth. SBT was used to fill the tooth when the months were February, April, June, August, October, and December.
Sponsors
Ya-Hsin Yu, DDS, MS
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Intervention model description
Non-surgical root canal treatment: All teeth were isolated with a rubber dam during root canal treatment. The procedures were performed under a microscope (OPMI Pico; Carl Zeiss, Gottingen, Germany). After access, location of canals, and determination of working length (WL) with Root ZX II apex locator (J Morita, Kyoto, Japan), the canals were instrumented using various .04 taper rotary NiTi instruments to a minimum apical size of 35. 4% NaOCl was used as the main irrigant. 17% EDTA was used as the final irrigant. Passive ultrasonic irrigation with size 20 Acteon tip inserted 2mm short of WL was performed with both 4% NaOCl and 17% EDTA for 10 seconds in each canal. After final irrigation, the canals were dried with paper points. The master gutta-percha cone fit was verified with periapical radiographs before filling the tooth.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Diagnosis of asymptomatic or symptomatic irreversible pulpitis according to AAE consensus. The diagnosis was based on clinical examinations and confirmed upon accessing the teeth. * Consenting adults age 18 years and older * Non-contributory medical history (ASA Class I & II) * Included patients were given oral and written information agreed for participation and signed the informed consent
Exclusion criteria
* Non-consenting patients and patients below 18 years of age * Medical history with ASA Class III & IV * Non-restorable teeth * Teeth with a non-vital pulp * Periodontal probing depths were more than 4mm * Pre-medication with antibiotics and/or analgesics 24 hours before the treatment * Patients taking analgesics routinely for non-dental reasons
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogue Scale (VAS) | 4-, 24-, and 48-hour after receiving root canal treatment | Patients were asked to rate the intensity of preoperative pain on a visual analogue scale (VAS) from 0 (no pain) to 10 (worst pain ever) before receiving root canal treatment. At the end of the visit, the patients were given a survey and asked to rate the intensity of postoperative pain (VAS 0-10) at 4 hours, 24 hours, and 48 hours after the procedure. |
Participant flow
Pre-assignment details
Only recruited irreversible pulpitis cases that received single-visit root canal treatment.
Participants by arm
| Arm | Count |
|---|---|
| Obturation Technique: WVT Warm vertical compaction technique (WVT): Teeth filled with AH Plus Jet Root Canal Sealer were filled with .04 taper gutta-percha points by WVT. The sealer was introduced with the master cone. The depth of heated plugger was within 3-5 mm of WL in the WVT group, and the remaining canal space was backfilled with additional sealer and thermoplasticized gutta-percha. | 41 |
| Obturation Technique: SBT Sealer-based filling technique (SBT): Teeth filled with SBT were obturated with EndoSequence BC Sealer by injecting the sealer into the coronal third of each canal. Size 30 Lentulo spiral coated with additional sealer was introduced 3 mm short of WL depth at 300rpm. Bioceramic coated gutta-percha was dipped in BC sealer and introduced into the canal to WL. A heated plugger was used to sear the gutta-percha point at each orifice. | 51 |
| Total | 92 |
Baseline characteristics
| Characteristic | Obturation Technique: WVT | Obturation Technique: SBT | Total |
|---|---|---|---|
| Age, Continuous | 46.2 years STANDARD_DEVIATION 14.4 | 46.7 years STANDARD_DEVIATION 16.6 | 46.5 years STANDARD_DEVIATION 15.6 |
| Race and Ethnicity Not Collected | — | — | 0 Participants |
| Sex: Female, Male Female | 30 Participants | 34 Participants | 64 Participants |
| Sex: Female, Male Male | 11 Participants | 17 Participants | 28 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 41 | 0 / 51 |
| other Total, other adverse events | 0 / 41 | 0 / 51 |
| serious Total, serious adverse events | 0 / 41 | 0 / 51 |
Outcome results
Primary
Visual Analogue Scale (VAS)
Patients were asked to rate the intensity of preoperative pain on a visual analogue scale (VAS) from 0 (no pain) to 10 (worst pain ever) before receiving root canal treatment. At the end of the visit, the patients were given a survey and asked to rate the intensity of postoperative pain (VAS 0-10) at 4 hours, 24 hours, and 48 hours after the procedure.
Time frame: 4-, 24-, and 48-hour after receiving root canal treatment
Population: The data from all 92 survey was included for analysis.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Obturation Technique: WVT | Visual Analogue Scale (VAS) | Preoperative | 4.06 score on a scale |
| Obturation Technique: WVT | Visual Analogue Scale (VAS) | Postoperative 4-hour | 2.41 score on a scale |
| Obturation Technique: WVT | Visual Analogue Scale (VAS) | Postoperative 24-hour | 1.95 score on a scale |
| Obturation Technique: WVT | Visual Analogue Scale (VAS) | Postoperative 48-hour | 1.15 score on a scale |
| Obturation Technique: SBT | Visual Analogue Scale (VAS) | Postoperative 48-hour | 1.00 score on a scale |
| Obturation Technique: SBT | Visual Analogue Scale (VAS) | Preoperative | 2.68 score on a scale |
| Obturation Technique: SBT | Visual Analogue Scale (VAS) | Postoperative 24-hour | 1.8 score on a scale |
| Obturation Technique: SBT | Visual Analogue Scale (VAS) | Postoperative 4-hour | 2.27 score on a scale |