Apical Periodontitis, Asymptomatic Infections, Post Operative Pain
Conditions
Keywords
Asymptomatic apical periodontitis, Diode laser, EDDY, EndoActivator, Post-operative pain
Brief summary
This randomized clinical trial aimed to evaluate post-operative pain (PP) in single-rooted teeth with asymptomatic apical periodontitis following final irrigation with sonic activation systems (EDDY and EndoActivator), with and without adjunctive 980-nm diode laser disinfection. Eighty patients were randomized into four groups: Group 1 (EDDY), Group 2 (EndoActivator), Group 3 (EDDY + laser), and Group 4 (EndoActivator + laser). PP intensity and analgesic intake were recorded at 8, 24, 48 hours, and on day 7. The study found no significant differences in PP or analgesic use among the groups, indicating that laser-assisted or different sonic activation methods did not reduce post-operative pain.
Detailed description
Post-operative pain (PP) is a common concern following root canal treatment, influenced by mechanical, chemical, and microbial factors. Effective irrigation and disinfection are crucial to remove debris and microorganisms from complex canal systems. This study investigated the effects of two sonic irrigation activation systems, EDDY and EndoActivator (EA), with and without 980-nm diode laser disinfection, on PP in patients with single-rooted teeth diagnosed with asymptomatic apical periodontitis. Eighty medically healthy adult patients (18-65 years) were randomly assigned to four groups. Group 1 underwent final irrigation with EDDY; Group 2 with EA; Group 3 with EDDY followed by laser irradiation; Group 4 with EA followed by laser irradiation. All procedures were completed in a single visit. PP was measured using a 0-10 numerical rating scale at 8, 24, 48 hours, and day 7. Analgesic consumption was also recorded. Statistical analysis showed no significant differences among groups for age, sex, PP scores, or analgesic intake. None of the patients experienced severe pain or swelling requiring emergency intervention. The findings suggest that both EDDY and EA sonic irrigation systems, with or without adjunctive 980-nm diode laser disinfection, do not significantly affect post-operative pain or analgesic use following single-visit root canal treatment of asymptomatic apical periodontitis. These results provide insight into the effectiveness of sonic irrigation activation and laser disinfection in routine endodontic practice, indicating that alternative techniques may be explored to optimize patient comfort and treatment outcomes.
Interventions
DEVICEEDDY sonic irrigation system
Sonic activation of irrigating solutions during endodontic treatment.
DEVICEEndoActivator (EA) sonic irrigation system
Sonic activation of irrigating solutions during endodontic treatment.
DEVICE980-nm diode laser
Diode laser irradiation during endodontic treatment.
Sponsors
Biruni University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Patients were blinded to the irrigation and disinfection method. The operator was not blinded due to the nature of the interventions. Post-operative pain was self-reported by patients using numerical rating scales and outcomes assesor was was not blinded to group allocation.
Intervention model description
Parallel-group randomized controlled trial
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Medically healthy adult patients aged 18-65 years * Patients diagnosed with asymptomatic apical periodontitis in permanent single-rooted teeth with closed apices and radiographic PAI score of 3 or 4 * Healthy periodontal conditions
Exclusion criteria
* Pregnant women * Patients with systemic disorders * Teeth with open apex, prosthetic restorations, mobility \> grade I, periodontal pocket depth \> 4 mm, non-restorable condition, calcified root canals, resorption, traumatic occlusion, or history of previous endodontic treatment * Patients who had taken analgesics within 12 hours prior to intervention * Patients who had received antibiotic therapy within the past month
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post-operative pain intensity | 8, 24, and 48 hours, and 7 days after the endodontic procedure | Pain intensity was self-reported by patients using a numerical rating scale (0-10), where 0 indicates no pain and 10 indicates the worst possible pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Analgesic consumption | 8, 24, and 48 hours, and 7 days after the endodontic procedure | Patients recorded the type, dosage, and timing of analgesics taken during the postoperative period. |
Countries
Turkey (Türkiye)
Outcome results
None listed