Comparison of the effect of photobiomodulation therapy and Ibuprofen on postoperative pain after endodontic treatment: randomized, controlled, clinical study.

The aim of the study was to compare the effect of Ibuprofen and the application of photobiomodulation therapy protocol on the reduction of postoperative pain in endodontically treated teeth using a randomized clinical trial design. Seventy patients, diagnosed with symptomatic irreversible pulpitis, were selected. Treatment was performed by a single operator; a reciprocal system was used to prepare the canals; they were obturated using the Tagger's hybrid technique and coronally sealed with glass-ionomer cement. After treatment, patients were randomly divided into 2 groups. In the active control group, two Ibuprofen 600 mg tablets were administered within a 12-h interval. In the photobiomodulation therapy group, the irradiation was applied after treatment. The evaluation of postoperative pain was performed by another researcher blinded to the groups at 6, 12, 24, and 72 h intervals after treatment. To measure the outcome, two pain scales were used: numerical rate scale (NRS) and verbal rate scale (VRS). Data were analyzed using the chi-square, Mann-Whitney, and Wilcoxon paired tests. Outcome was superior with photobiomodulation therapy at 6 h (p < 0.001), 12 h (p = 0.005), and 24 h (p < 0.001) intervals compared with Ibuprofen. The results for the 72 h (p = 0.317) interval were similar, both in the VRS and NRS scales. It may be concluded that the use of photobiomodulation therapy was effective in reducing pain within the first 24 h when compared with the administration of Ibuprofen 600 mg.

Effect of photobiomodulation therapy on postoperative pain after endodontic treatment: a randomized, controlled, clinical study.

OBJECTIVE: The aim of this prospective, randomized, clinical study was to assess the effect of photobiomodulation therapy (PBM) with low-level laser irradiation (LLLI) on postoperative pain after endodontic treatment. MATERIALS AND METHODS: Sixty patients, diagnosed with irreversible pulpitis in lower molar teeth, participated in the study. All treatments were performed by a single operator. Participants were randomly divided into two groups: in the experimental group (EG), endodontic treatment was performed with a reciprocating system, immediately followed by PBM with LLLI; and only endodontic treatment was performed in the control group (CG). Postoperative pain was assessed by a second examiner, who was blinded, using two scales: verbal rating scale (VRS) and numerical rating scale (NRS). Assessment was carried out at 6, 12, and 24 h after treatment. Data were analyzed using chi-squared, Fisher's exact, Mann-Whitney tests, ordinal, and non-parametric regression analyses. RESULTS: For the prevalence of pain, the difference between the groups was significant for the evaluations performed after 6 h (p = 0.04) and 24 h (p = 0.02). The difference after 24 h remained significant after stratification by sex and extrusion of filling material. Increased pain intensity was associated with extrusion of root canal filling material to the periapical region in the two scales used. CONCLUSION: The effect of PBM therapy after endodontic treatment showed a significant decreasein prevalence of postoperative pain. CLINICAL RELEVANCE: The PBM reduces the prevalence of postoperative pain and may benefit patients who need endodontic treatment.

Technological advances in endodontics: treatment of a mandibular molar with internal root resorption using a reciprocating single-file system.

The field of endodontics has become increasingly successful due to technological advances that allow clinicians to solve clinical cases that would have been problematic a few years ago. Despite such advances, endodontic treatment of teeth with internal root resorption remains challenging. This article presents a clinical case in which a reciprocating single-file system was used for endodontic treatment of a mandibular molar with internal root resorption. Radiographic examination revealed the presence of internal root resorption in the distobuccal root canal of the mandibular right first molar. A reciprocating single-file system was used for root canal instrumentation and final preparation, and filling was obtained through a thermal compaction technique. No painful symptoms or periapical lesions were observed in 12 months of follow-up. The results indicate that a reciprocating single-file system is an adequate alternative for root canal instrumentation, particularly in teeth with internal root resorption.

Assessment of postoperative pain after reciprocating or rotary NiTi instrumentation of root canals: a randomized, controlled clinical trial.

OBJECTIVES: The aim of this study was to assess postoperative pain in a prospective randomized clinical trial comparing two groups, using the Reciproc® system in one group and the ProTaper® rotary system in the other. MATERIAL AND METHODS: The study included 78 male patients, aged 18-64 years (mean age of 26 years), with asymptomatic pulp necrosis in mandibular molar teeth (n = 78). The single-session endodontic treatment was performed by a single operator specialized in Endodontics. Mechanical preparation of the root canals was performed using the ProTaper® and Reciproc® instrumentation techniques. Postoperative pain was recorded using a verbal rating scale (VRS) and verbal description with well-defined categories at the three following time intervals: 24 h, 72 h, and 7 days after the endodontic procedure. The assessment of postoperative pain was recorded as no pain, mild pain, moderate pain, and severe pain or flare-up. Data were analyzed using the nonparametric Mann-Whitney test with the aid of the STATA® software. RESULTS: The incidence of postoperative pain in the ProTaper group (PT) 24 h after the endodontic procedure was 17.9 and 5.1 % after 72 h. In the Reciproc group (RP), the incidence after 24 h was 15.3 and 2.5 % after 72 h. No patients presented severe pain at the time intervals assessed. CONCLUSIONS: No significant difference (p > 0.05) in postoperative pain was found between the ProTaper® and Reciproc® instrumentation technique during endodontic treatment in this study. CLINICAL RELEVANCE: According to our findings and the results of the clinical trial, the occurrence of postoperative pain was low and similar between the reciprocating and rotary techniques during the time intervals assessed. These results are different from basic laboratory studies that affirm that the reciprocating techniques tend to promote more postoperative pain since extrusion of debris is greater.

Injection of sodium hypochlorite beyond the apical foramen--a case report.

The aim of this study was to report a clinical case of extravasation of 1% sodium hypochlorite into the periapical tissues during endodontic treatment. During apical debridement, absence of reflux of the irrigating solution was observed, followed by root canal hemorrhage. The patient immediately complained of intense pain, and a profuse edema and hyperemia was observed on the left side of her face compatible with extravasation of hypochlorite to the periapex. The patient was treated with ibuprofen 600 mg three times per day for three days, a single dose of dexamethasone 4 mg, amoxicillin 500 mg three times per day for seven days, and a cold compress for two days. Regression of the condition began on the fourth day, and normal tissue aspect and absence of sequelae were observed on the 14th day.

Shaping Ability of Reciprocating and Rotary Systems After Root Canal Retreatment: a CBCT Study.

The purpose of this in vitro study was to evaluate the shaping ability of reciprocating and continuous rotary systems after root canal retreatment. After preparation and root canal filling, mesial canals of 54 mandibular molars were distributed into 3 groups (n=18), according to the filling material removal and re-instrumentation protocols: WOG group - WaveOne Gold system; PTN group - ProTaper Next system; and PTU group - ProTaper Universal system. Cone-beam computed tomographic (CBCT) images acquisition of the mesial root canals was performed at different moments: (1) before instrumentation (unprepared root canals), (2) after preparation and filling, (3) after filling material removal and (4) re-instrumentation. The apical transportation (AT), centering ability (CA) and change in root canal diameter were assessed by CBCT analysis. The remaining filling material quantification was performed by radiographic examination. The statistical analyses were performed using the 3-way ANOVA, Tukey-Kramer, Kruskal-Wallis and Dunn multiple Comparison tests (p<0.05). The tested instruments did not show full CA (=1.0). PTN group had greater AT at the 5th mm in comparison with the WOG group (p<0.05). After re-instrumentation, WOG group had greater root canal diameter change at the 1st and 5th mm than PTN and PTU groups (p<0.05). There was no significant difference among groups when comparing the amount of remaining filling material after re-instrumentation (p>0.05). The tested systems provided minimal alteration in root canal morphology at the apical portion after root canal retreatment. However, WOG promoted greater change in root canal diameter.

Effect of Occlusal Adjustment on Postoperative Pain after Root Canal Treatment: A Randomized Clinical Trial.

The aim of this prospective, randomized, clinical study was to analyze the influence of occlusal adjustment on the prevalence of postoperative pain after endodontic treatment. Seventy-eight patients, diagnosed with symptomatic irreversible pulpitis with indication for endodontic treatment, were selected to participate in the study. The participants were randomized and divided into two groups: in the occlusal adjustment group (OAG), endodontic treatment was performed with subsequent occlusal adjustment. In the control group (CG), endodontic treatment was performed without occlusal adjustment. Treatments were performed by the same operator. Pain occurrence and intensity were recorded on two scales: the verbal rating scale (VRS) and numerical rating scale (NRS). Pain assessment was carried out by a second examiner, blinded to the experiment, 6, 24 and 72 h after endodontic treatment. Data were analyzed using Mann-Whitney, chi-squared, and Fisher's exact tests. In the occlusal adjustment group, 71.1% reported postoperative pain and 67.5% reported pain in the control group. At the 6-hour assessment, 21 individuals reported pain in the occlusal adjustment group and 24 in the control group (p=0.672). At the 24-hour assessment, 18 and 19 individuals reported pain (p=0.991) and at the 72-hour assessment, 8 and 4 reported pain (p=0.219), respectively. Occlusal adjustment did not influence the prevalence of postoperative pain of endodontically treated teeth with symptomatic irreversible pulpitis.

Apical Transportation and Centering Ability After Root Canal Filling Removal Using Reciprocating and Continuous Rotary Systems: A CBCT Study.

OBJECTIVE: To evaluate the apical transportation and centering ability promoted by reciprocating and continuous rotary systems after root canal filling removal. MATERIALS AND METHODS: After obturation, 40 mesial root canals of mandibular molars were distributed into four groups (n = 20) for filling material removal: PTU group-F2 instrument (25.08) of ProTaper Universal system; R25 group-R25 instrument (25.08) of Reciproc system; X2 group-X2 instrument (25.06) of ProTaper Next system and X3 group-X2 instrument (25.06) of ProTaper Next system, followed by X3 instrument (30.07). Cone-beam computed tomographic analysis was performed before and after filling material removal for acquisition of apical images. Apical transportation (AT) and its direction, and centering ability (CA), were assessed using the equations AT = (X1-X2)-(Y1-Y2) and CA = (X1-X2/Y1-Y2 or Y1-Y2/X1-X2), respectively. Data were submitted to the nonparametric Kruskal-Wallis and Dunn multiple comparison tests (p < 0.05) for statistical analysis. RESULTS: There was no statistically significant difference among groups for AT (p > 0.05), with a tendency toward transportation in the distal direction. Also, there was no statistically significant difference among groups regarding CA (p > 0.05). CONCLUSIONS: The different systems, including ProTaper Next, caused AT within the acceptable clinical limit after filling removal. In addition, none of the tested systems presented adequate CA.

Filling Material Removal with Reciprocating and Rotary Systems Associated with Passive Ultrasonic Irrigation.

OBJECTIVE: The purpose of this ex vivo study was to evaluate the filling material removal ability, and the time required to perform this procedure, of reciprocating and conventional rotary systems when associated with passive ultrasonic irrigation. METHODS: The palatal roots of 40 maxillary molars were submitted to root canal preparation and filling. The desobturation of root canals was initially performed with Largo burs in the coronal portion (4 mm) to drill the gutta-percha and to facilitate the action of the instruments used then. Next, the palatal roots were randomly distributed (n=10) according to the systems and irrigation protocols used for filling material removal: ProTaper universal retreatment (PTR), PTR+passive ultrasonic irrigation (PUI) (PTR+PUI), Reciproc system (RS), and RS+PUI. Passive ultrasonic activation was performed in the root canals completely filled with 2.5% sodium hypochlorite solution using a smooth and straight ultrasonic tip, coupled to a low-power (20%) ultrasonic device for 1 min (3 cycles of 20 s). After retreatment, the roots were longitudinally sectioned to the remaining filling material quantification using an operating microscope. Environmental scanning electron microscopy (ESEM) micrographs at 97, 105, and 250 X magnifications were also taken to evaluate the quantity of filling material present at the apical portion of the palatal roots. RESULTS: The RS group presented greater quantity of filling material attached to the root canal walls than the other groups (P>0.05). PTR+PUI and RS+PUI groups were statistically similar (P>0.05). Reinstrumentation of root canals using RS was faster than PTR, irrespective of the irrigation protocol used (P>0.05). CONCLUSION: The association between PUI and the different systems for reinstrumentation yielded greSater filling material removal. The reciprocating system was faster.

Topographic and Chemical Analysis of Reciprocating and Rotary Instruments Surface after Continuous Use.

This study aimed at evaluating the changes in surface characteristics and NiTi content of reciprocating and rotary instruments after continuous use. Thirty brand-new instruments were assigned to 3 groups (n=10): PNX1 Group - ProTaper Next system - instrument X1; PNX2 Group - ProTaper Next system - instrument X2 and WO Group - WaveOne system - Primary instrument 25.08. The instruments were used to prepare 60 simulated root canals. Analysis of surface characteristics by scanning electron microscopy (SEM) and chemical analysis of Ni and Ti content by energy-dispersive spectroscopy (EDS) were performed before and after the first and third use of the instruments. Only WO Group had significant increase in the quantity of defects and deformations after the third use (p<0.05). PNX1 Group had significant decrease in Ni content after the third use, in comparison with the unused instruments (p<0.05). PNX1 Group had no decrease in Ti content throughout the time of use (p>0.05), however, in PNX2 Group, there was significant decrease in the different time interval of analysis (p<0.05). Continuous use promoted increase in defects and deformations only for WaveOne instruments. Chemical composition presented significant changes according to the time of instruments use.

Assessment of a Cavity to Optimize Ultrasonic Efficiency to Remove Intraradicular Posts.

INTRODUCTION: The study assessed an in vitro protocol for the removal of cast metal posts using ultrasonic vibration in multirooted teeth by drilling a cavity in the coronal portion of the post followed by ultrasound application in the cavity. METHOD: Forty endodontically treated molars received intraradicular cast posts and were divided into 4 groups according to the removal protocol: the control group, no cavity and no ultrasonic vibration; the ultrasonic group, no cavity and ultrasonic vibration in the coronal portion of the core; the cavity group, a cavity in the core and no ultrasonic vibration; and the cavity ultrasonic group, a cavity in the core and ultrasonic vibration inside the cavity. The traction test was performed on all samples using a universal testing machine (EMIC DL-2000; EMIC Equipamentos e Sistemas de Ensaio LTDA, São José dos Pinhais, PR, Brazil) at a speed of 1 mm/min, obtaining values in Newtons. The data were statistically analyzed using analysis of variance and the Tukey-Kramer test (P < .05). RESULTS: The results showed statistically significant differences between the tested groups (control group = 322.74 N, ultrasonic group = 283.09 N, cavity group = 244.00 N, and cavity ultrasonic group = 237.69 N). The lowest mean strength was found in the group that received ultrasonic vibration inside the cavity. CONCLUSIONS: Preparing a cavity in the coronal core followed by ultrasonic vibration reduces the traction force required for removal. The removal protocol was effective for removing posts in multirooted teeth cemented with zinc phosphate.

Shaping Ability of Reciprocating and Rotary Systems After Root Canal Retreatment: a CBCT Study

Abstract The purpose of this in vitro study was to evaluate the shaping ability of reciprocating and continuous rotary systems after root canal retreatment. After preparation and root canal filling, mesial canals of 54 mandibular molars were distributed into 3 groups (n=18), according to the filling material removal and re-instrumentation protocols: WOG group - WaveOne Gold system; PTN group - ProTaper Next system; and PTU group - ProTaper Universal system. Cone-beam computed tomographic (CBCT) images acquisition of the mesial root canals was performed at different moments: (1) before instrumentation (unprepared root canals), (2) after preparation and filling, (3) after filling material removal and (4) re-instrumentation. The apical transportation (AT), centering ability (CA) and change in root canal diameter were assessed by CBCT analysis. The remaining filling material quantification was performed by radiographic examination. The statistical analyses were performed using the 3-way ANOVA, Tukey-Kramer, Kruskal-Wallis and Dunn multiple Comparison tests (p<0.05). The tested instruments did not show full CA (=1.0). PTN group had greater AT at the 5th mm in comparison with the WOG group (p<0.05). After re-instrumentation, WOG group had greater root canal diameter change at the 1st and 5th mm than PTN and PTU groups (p<0.05). There was no significant difference among groups when comparing the amount of remaining filling material after re-instrumentation (p>0.05). The tested systems provided minimal alteration in root canal morphology at the apical portion after root canal retreatment. However, WOG promoted greater change in root canal diameter.

Resumo O objetivo deste estudo in vitro foi avaliar a capacidade de modelagem de sistemas rotatórios e reciprocantes após o retratamento do canal radicular. Após o preparo e obturação do canal radicular, os canais mesiais de 54 molares inferiores foram distribuídos em 3 grupos, de acordo com os protocolos de remoção do material obturador e re-instrumentação: (n=18): grupo WOG - sistema WaveOne Gold; Grupo PTN - sistema ProTaper Next; e grupo PTU - sistema ProTaper Universal. A análise das imagens de tomografia computadorizada de feixe cônico foi realizada em diferentes momentos: (1) antes da instrumentação (canais radiculares não preparados), (2) após o preparo e obturação, (3) após a remoção do material obturador e (4) re-instrumentação. O transporte apical (TA), a capacidade de centralização (CC) e a mudança no diâmetro do canal radicular foram avaliados por análise tomográfica. A quantificação do restante do material obturador foi realizada por exame radiográfico. As análises estatísticas foram realizadas utilizando os testes de ANOVA de 3 fatores, Tukey-Kramer, Kruskal-Wallis e Comparações Múltiplas de Dunn (p<0,05). Os instrumentos não apresentaram CC perfeita (=1,0). PTN apresentou maior TA no 5º mm em comparação ao grupo WOG (p<0,05). Após a re-instrumentação, o grupo WOG apresentou maior aumento no diâmetro do canal radicular no 1° e 5° mm do que os grupos PTN e PTU. Não houve diferença significativa entre os grupos em relação à remoção do material obturador (p>0,05). Os sistemas testados proporcionaram alteração mínima na morfologia do canal radicular na porção apical após o retratamento do canal radicular. No entanto, WOG promoveu maior alteração no diâmetro do canal radicular.

Smear layer removal and chelated calcium ion quantification of three irrigating solutions.

The purpose of this study was to evaluate, by scanning electron microscopy (SEM), smear layer removal and quantify, by atomic absorption spectrophotometry, the amount of calcium ion present in the chelating solutions after their use. Sixteen extracted canines were instrumented using the step-back technique and were assigned to 3 groups according to the irrigating solution used: G1: 1 mL 17% EDTAC between each file; G2: 1 mL 17% CDTA; G3: 1 mL 17% EGTA. The solutions were collected after use. The teeth were cleaved longitudinally, evaluated under SEM and assessed for smear layer by blinded examiners and scored from 1 to 4. In order to quantify calcium ion release, the collected solutions were examined by atomic absorption spectrophotometry. Freidman's test was used for statistical analysis of SEM values and showed that canals irrigated with 17% EDTAC and 17% CDTA had significantly less smear layer throughout the canals than 17% EGTA (p<0.01). For analysis of the collected solutions, Tukey's test was used and showed that EDTAC and CDTA had a greater amount of calcium ions (22.8+/-7.54 and 60.6+/-20.67 microg/mL, respectively) compared to EGTA (70.5+/-14.2 microg/mL) (p<0.01). The association both methodologies may contribute to the understanding of how these solutions act in the root canal.

Cleaning Effectiveness of a Reciprocating Single-file and a Conventional Rotary Instrumentation System.

OBJECTIVE: To compare cleaning effectiveness by histological analysis of a reciprocating single-file system with ProTaper rotary instruments during the preparation of curved root canals in extracted teeth. METHODS: A total of 40 root canals with curvatures ranging between 20 - 40 degrees were divided into two groups of 20 canals. Canals were prepared to the following apical sizes: Reciproc size 25 (n=20); ProTaper: F2 (n=20). The normal distribution of data was tested by the Kolmogorov-Smirnov test and the values obtained for the test (Mann-Whitney U test, P < .05) were statistically analyzed using the GraphPad InStat for the Mac OS software (GraphPad Software, La Jolla, CA, USA). RESULTS: There were no significant differences in remaining debris (P > .05) between the two groups. CONCLUSION: The application of reciprocating motion during instrumentation did not result in increased debris when compared with continuous rotation motion, even in the apical part of curved canals. Both instruments resulted in debris in the canal lumen, irrespective of the movement kinematics applied.

Evaluation of a new protocol for removing metal retainers from multirooted teeth.

INTRODUCTION: The aim of this study was to evaluate in vitro a new protocol for removing intraradicular retainers from multirooted teeth applying ultrasonic vibration. METHODS: Forty mandibular molars were endodontically treated to receive cast intraradicular retainers, which were distributed into the following 4 groups: group 1: control without a slot and without ultrasound, group 2: control with a slot and without ultrasound, group 3: ultrasonic vibration in the core without a slot, and group 4: ultrasonic vibration in the core with a slot. After the intraradicular retainers were cemented with zinc phosphate, ultrasonic vibration was applied for 1 minute. The test specimens were then submitted to the traction test in the universal testing machine at a speed of 1 mm/min. The maximum traction force required to remove the intraradicular retainer was recorded in newtons, and the data were statistically analyzed using analysis of variance and the Tukey-Kramer test (P < .05). RESULTS: The results showed statistically significant differences among the groups tested (group 1 = 234.34 N, group 2 = 201.67 N, group 3 = 139.57 N, and group 4 = 83.23 N). The lowest mean value of traction force recorded was when ultrasonic vibration was applied on the core with a slot. CONCLUSIONS: Creating a slot in the core and the ultrasound application on all surfaces and inside the slot reduced the force required for removing intraradicular metal retainers from multirooted teeth cemented with zinc phosphate.

Root canal retreatment using reciprocating and continuous rotary nickel-titanium instruments.

OBJECTIVE: The complete filling material removal during endodontic retreatment is a clinical procedure difficult to achieve. The aim of this study was to evaluate the efficacy of reciprocating and continuous rotary nickel-titanium instruments used in root canal retreatment. MATERIALS AND METHODS: Forty freshly extracted human premolars were cleaned and shaped by the crown-down technique, followed by filling by the lateral compaction technique. The teeth were randomly separated into two groups (n = 20), according to the system used for filling material removal: G1 - Reciproc and G2 - ProTaper Universal Retreatment System. The teeth were photographed under operating microscope at ×8 magnification; and the total area of the root canal and remaining filling material were quantified. RESULTS: No statistically significant difference (P > 0.05) in residual filling material was observed between groups; however, the time required for filling removal was significantly shorter for Reciproc system (P < 0.05). CONCLUSIONS: It was observed remaining filling material in all teeth, irrespective of the system used; however, root canal retreatment was faster when reciprocating motion was used.

Apical Transportation, Centering Ability, and Cleaning Effectiveness of Reciprocating Single-file System Associated with Different Glide Path Techniques.

INTRODUCTION: The aim of this study was to evaluate the apical transportation, the centering ability, and the cleaning effectiveness of a reciprocating single-file system associated to different glide path techniques. METHODS: The mesial root canals of 52 mandibular molars were randomly distributed into 4 groups (n = 13) according to the different glide path techniques used before biomechanical preparation with Reciproc System (RS): KF/RS (sizes 10 and 15 K-files), NGP/RS (no glide path, only reciprocating system), PF/RS (sizes 13, 16, and 19 PathFile instruments), and NP (no preparation). Cone-beam computed tomography analysis was performed before and after instrumentation for apical third images acquisition. Apical transportation and its direction were evaluated by using the formula D = (X1 - X2) - (Y1 - Y2), and the centering ability was analyzed by the formula CC = (X1 - X2/Y1 - Y2 or Y1 - Y2/X1 - X2). The samples were submitted to histologic processing and analyzed under a digital microscope for debris quantification. The values were statistically analyzed (Kruskal-Wallis, the Dunn multiple comparisons test, P < .05). RESULTS: All groups had similar apical transportation values, with no significant difference among them (P > .05). Groups had a tendency toward transportation in the mesial direction. No technique had perfect centering ability (=1.0), with no significant difference among them. KF/RS had larger amount of debris, with statistically significant difference in comparison with NGP/RS (P > .05). CONCLUSIONS: The different glide path techniques promoted minimal apical transportation, and the reciprocating single-file system tested remained relatively centralized within the root canal. Also, the different techniques interfered in the cleaning effectiveness of the reciprocating system.

Histological evaluation of the cleaning effectiveness of two reciprocating single-file systems in severely curved root canals: Reciproc versus WaveOne.

OBJECTIVE: The aim of this study was to evaluate the cleaning effectiveness achieved with two reciprocating single-file systems in severely curved root canals: Reciproc and WaveOne. MATERIALS AND METHODS: Twenty-five mesial roots of mandibular molars were randomly separated into two groups, according to the instrumentation system used. The negative control group consisted of five specimens that were not instrumented. The mesial canals (buccal and lingual) in Reciproc Group were instrumented with file R25 and the WaveOne group with the Primary file. The samples were submitted to histological processing and analyzed under a digital microscope. RESULTS: The WaveOne group presented a larger amount of debris than the Reciproc Group, however, without statistically significant difference (P > 0.05). A larger amount of debris in the control group was observed, with statistically significant difference to Reciproc and WaveOne groups (P < 0.05). CONCLUSIONS: The two reciprocating single-file instrumentation systems presented similar effectiveness for root canal cleaning.

Effect of occlusal adjustment on postoperative pain after root canal treatment: a randomized clinical trial

Abstract The aim of this prospective, randomized, clinical study was to analyze the influence of occlusal adjustment on the prevalence of postoperative pain after endodontic treatment. Seventy-eight patients, diagnosed with symptomatic irreversible pulpitis with indication for endodontic treatment, were selected to participate in the study. The participants were randomized and divided into two groups: in the occlusal adjustment group (OAG), endodontic treatment was performed with subsequent occlusal adjustment. In the control group (CG), endodontic treatment was performed without occlusal adjustment. Treatments were performed by the same operator. Pain occurrence and intensity were recorded on two scales: the verbal rating scale (VRS) and numerical rating scale (NRS). Pain assessment was carried out by a second examiner, blinded to the experiment, 6, 24 and 72 h after endodontic treatment. Data were analyzed using Mann-Whitney, chi-squared, and Fisher's exact tests. In the occlusal adjustment group, 71.1% reported postoperative pain and 67.5% reported pain in the control group. At the 6-hour assessment, 21 individuals reported pain in the occlusal adjustment group and 24 in the control group (p=0.672). At the 24-hour assessment, 18 and 19 individuals reported pain (p=0.991) and at the 72-hour assessment, 8 and 4 reported pain (p=0.219), respectively. Occlusal adjustment did not influence the prevalence of postoperative pain of endodontically treated teeth with symptomatic irreversible pulpitis.

Resumo O objetivo deste estudo prospectivo, randomizado e clínico foi analisar a influência do ajuste oclusal na prevalência de dor pós-operatória após o tratamento endodôntico. Setenta e oito pacientes, diagnosticados com pulpite irreversível sintomática com indicação de tratamento endodôntico, foram selecionados para participar do estudo. Os participantes foram randomizados e divididos em dois grupos: no grupo de ajuste oclusal (GAO), foi realizado tratamento endodôntico com posterior ajuste oclusal. No grupo controle (GC), o tratamento endodôntico foi realizado sem ajuste oclusal. Os tratamentos foram realizados pelo mesmo operador. A ocorrência e a intensidade da dor foram registradas em duas escalas: a escala de classificação verbal (VRS) e a escala de classificação numérica (NRS). A avaliação da dor foi realizada por um segundo examinador, cego para o experimento, 6, 24 e 72 horas após o tratamento endodôntico. Os dados foram analisados utilizando testes de Mann-Whitney, qui-quadrado e exato de Fisher. No grupo de ajuste oclusal, 71,1% relataram dor pós-operatória e 67,5% relataram dor no grupo controle. Na avaliação de 6 horas, 21 indivíduos relataram dor no grupo de ajuste oclusal e 24 no grupo controle (p=0,672). Na avaliação de 24 horas, 18 e 19 indivíduos relataram dor (p=0,991) e, na avaliação de 72 horas, 8 e 4 relataram dor (p=0,219), respectivamente. O ajuste oclusal não influenciou a prevalência de dor pós-operatória após o tratamento endodôntico em dentes com pulpite irreversível sintomática.