Non-surgical Retreatment
Conditions
Keywords
Non-surgical retreatment, Operation time, Postoperative pain, Visual analog scale
Brief summary
This prospective, randomized, single-center, single-blind clinical trial evaluated the effects of different nickel-titanium retreatment and final shaping systems on postoperative pain and operation time during single-visit nonsurgical endodontic retreatment of mandibular first molars. Participants were allocated to four groups according to the combination of the retreatment system used for root canal filling removal and the rotary or reciprocating system used for final root canal shaping. Postoperative pain, analgesic consumption, and operation time were assessed and compared among the groups.
Detailed description
Postoperative pain is a common complication following nonsurgical endodontic retreatment and may be influenced by the instrumentation system used during root canal filling removal and final root canal shaping. This prospective, single-center, single-blind, randomized clinical trial was designed to compare the effects of different nickel-titanium instrumentation protocols on postoperative pain and operation time in mandibular first molar teeth requiring nonsurgical endodontic retreatment. Adult participants aged 18-65 years with previously endodontically treated mandibular first molars meeting the eligibility criteria were included. All retreatment procedures were performed in a single visit by one endodontist. Participants were randomly allocated to one of four parallel treatment groups. Existing root canal filling materials were removed using either the ProTaper Universal Retreatment system or the MicroMega REMOVER system. Final root canal shaping was then performed using either the ProTaper Next rotary system or the MicroMega One RECI reciprocating system. Thus, the four intervention groups consisted of ProTaper Universal Retreatment plus ProTaper Next, ProTaper Universal Retreatment plus MicroMega One RECI, MicroMega REMOVER plus ProTaper Next, and MicroMega REMOVER plus MicroMega One RECI. Postoperative pain intensity was assessed using a 100-mm visual analog scale, in which 0 represented no pain and 100 represented unbearable pain. Participants recorded their pain levels at 6 and 12 hours and on postoperative days 1, 2, 3, 4, 5, 6, and 7. The use and frequency of rescue analgesic medication were also recorded during the seven-day follow-up period. Clinical evaluations were performed at 48 hours and seven days to assess pain, tenderness to percussion, spontaneous pain, swelling, and the need for antibiotic treatment. Operation time was recorded using a digital stopwatch. The recorded period included the time from the initial penetration into the existing root canal filling material until working length was reached and final root canal shaping was completed. Postoperative pain scores, analgesic consumption, and operation time were compared among the four instrumentation groups.
Interventions
DEVICEProTaper Universal Retreatment System
A nickel-titanium rotary retreatment system used for the removal of existing root canal filling materials during nonsurgical endodontic retreatment.
DEVICEMicroMega REMOVER
A nickel-titanium rotary retreatment instrument used for the removal of existing root canal filling materials during nonsurgical endodontic retreatment.
DEVICEProTaper Next
A nickel-titanium rotary instrumentation system used for final root canal shaping following the removal of existing root canal filling materials.
DEVICEOne RECI
A nickel-titanium reciprocating instrumentation system used for final root canal shaping following the removal of existing root canal filling materials.
Sponsors
Aydin Adnan Menderes University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients between 18- 65 years of ages * Patients who agree to participate this study * Patients had not used analgesic or antibiotics in last 7 days * Mandibular molar teeth that have been endodontically treated only once * Asymptomatic teeth with previous endodontic treatment but exhibiting inadequate root canal filling on radiographic examination. * Teeth, although asymptomatic, but with newly developed periapical radiolucency within two years compared to the radiographic findings present 2 years ago at the time of root canal treatment was done. * Teeth with periapical radiolucency, but with increased or unchanged according to pre-treatment radiography. * Absence of a history of allergy to local anesthetics, medications, resin-based restorative materials or nickel.
Exclusion criteria
* Pregnant patients and patients in lactation period * Having used corticosteroids in the last 6 months. * Individuals with systemic diseases (endocarditis, immune system diseases, etc.) requiring antibiotic prophylaxis * Having received immunosuppressive therapy within the last week * Gingival recession exceeding 3 mm, deep periodontal pocketing, tooth mobility, or progressive periodontal disease * The presence of a foreign body in the root canal that prevents entry (broken file, post, etc.) * Fracture or crack in the root * Teeth that cannot reach the working length due to calcification in the root canal and step formation * Teeth that cannot be restored due to excessive loss of material in the coronal structure * The presence of more than one adjacent tooth requiring endodontic treatment that may cause reflected pain in the same patient. * Teeth that develop any complications (breakage of endodontic file, perforation, inability to determine the working length with the apex finder) during the removal of the canal filling material.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain Intensity | At 6, 12, 24, and 48 hours and on postoperative days 3, 4, 5, 6, and 7 after treatment. | Postoperative pain intensity was assessed using a 100-mm visual analog scale, where 0 indicated no pain and 100 indicated the worst imaginable pain. Pain scores were compared among the four instrumentation groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Operation Time | During the single-visit nonsurgical endodontic retreatment procedure. | The total time required to remove the existing root canal filling material and complete final root canal shaping was recorded in minutes for each participant and compared among the four instrumentation groups. |
Countries
Turkey (Türkiye)
Outcome results
None listed