The Effects Of Dıfferent Irrıgatıon Methods Used In Endodontıc Therapy On Postoperatıve Paın: Prospectıve Randomısed Clınıcal Trıal


Thesis Type: Doctorate

Institution Of The Thesis: Gazi University, Turkey

Approval Date: 2017

Thesis Language: Turkish

Student: Adil Ekici

Supervisor: BAĞDAGÜL HELVACIOĞLU KIVANÇ

Abstract:

The aims of this study was to evaluate the postoperative level of pain after activation of irrigation solution using sonic and ultrasonic systems and to compare it with syringe irrigation. 114 volunteer patients with 150 teeth were included in this study. The volunteers were aged 18 and 76 years, had no systemic diseases or allergies. Diagnoses were either asymptomatic irreversible pulpitis caused by carious exposures or normal pulp if the patient had been referred for prosthetic reasons, single-rooted teeth with one canal with vital pulp were selected for the investigation. All canals prepared using nickel-titanium rotary instruments. Apical patency was established and verified with #10 K-file during root canal theraphy. The same volume of final irrigation solution was used for all root canals. The teeth were divided into three groups as syringe irrigation (SI), passiveultrasonic irrigation (PUI) and sonic irrigation (EA). In syringe irrigation group (SI), canals were irrigated with 5 mL of 2.5% NaOCl, 2 ml 17% EDTA, 2 ml sterile saline using 27-gauge needle placed 2 mm short of working length with a flow rate of 2 ml min-1, respectively. In passive ultasonic irrigation (PUI) group, 5 ml 2.5% NaOCl was delivered into canal with syringe and activated with ultrasonic tip and ultrasonic device at power setting 3 for a min. In sonic irrigation group (EA), 5 ml 2.5% NaOCl was delivered into canal with syringe and activated with EndoActivator tip at 10000 cycles/min for a min. All patients were informed about postoperative pain and given eight tablets of ibuprofen 200 mg with the instructions if it was necessary in the event of pain. 150 questionnaires (50 teeth from the all groups) were obtained and evaluated by statistical analysis. In group SI, pain level at 4-h was significantly more higher than pain level at 48-h (p<0.05) but also, there were no statistically significant differences between pain level at 4-h and 24-h, 24- h and 48-h (p>0.05). In group PUI, pain level at 4-h was significantly more higher than pain level at 48-h (p<0.05) but also, there were no statistically signifcant differences between pain level at 4-h and 24-h, 24- h and 48-h (p>0.05). In group EA, pain level at 4-h was statistically significant more higher than pain levels at 48-h (p<0.05) but also, there were no statistically significant differences between pain levels at 4-h and 24-h, 24- h and 48-h (p>0.05). There was no statistically significant differences between the groups at all time intervals (p>0.05). In addition, no statistically significant difference was observed in the mean number of analgesic tablets consumed between the groups at all time intervals (p>0.05). Within the limitations of this study, the postoperative pain scores and necessity for analgesic intake were not significantly difference between the irrigation activation protocols.