The Effect of Foraminal Enlargement of Necrotic Teeth with a Continuous Rotary System on Postoperative Pain: A Randomized Controlled Trial.

INTRODUCTION: This single-blind, randomized controlled trial aimed to evaluate whether foraminal enlargement (FE) with a continuous rotary system during endodontic treatment causes more postoperative pain than nonforaminal enlargement (NFE). METHODS: Seventy qualified patients were randomized into 1 of 2 groups in a 1:1 ratio using a series of random numbers: the FE group and the NFE group. The patients were followed up for 7 days to evaluate between-group differences in the outcome measures. The study participants were selected from among patients who had necrosis and apical periodontitis in the maxillary or mandibular molar teeth. The primary outcome was to assess postoperative pain severity, and the secondary outcome was to evaluate analgesic consumption during the follow-up period. Pain severity was evaluated for the first 7 days using a visual analog scale (VAS). The VAS consisted of a 100-mm line. Pain severity was assessed as no pain (0-4 mm), mild pain (5-44 mm), moderate pain (45-74 mm), and severe pain (75-100 mm). The quality of life of patients during the follow-up period was assessed using a quality of life scale. The Student t test was used to identify statistically significant differences between the study groups (P < .05). RESULTS: A significant difference was noted in postoperative pain in the first 2 days; the FE group experienced more pain than the conventional NFE group (P < .05). In the FE group, 12 and 11 patients (34% and 31%) had severe postoperative pain (VAS score, >74 mm) on the first day and second day, respectively. VAS pain scores between the groups were not different (P > .05) on other days. No significant difference was found in analgesic consumption between the groups (P > .05). CONCLUSIONS: On the basis of the VAS results, this randomized controlled trial indicates that FE causes more pain on the first 2 days after an endodontic treatment.

Root canal shaping using rotary nickel-titanium files in preclinical dental education in Turkey.

The purposes of this study were to evaluate the ability of a group of third-year dental students without any endodontic clinical experience to use the ProTaper Instruments (Dentsply Maillefer) to decrease the amount of straightening of curved canals on human molar teeth and to determine the incidence of instrument fractures and instrumentation time. Thirty-one undergraduate dental students in Turkey received a training session. The students prepared a total of 144 root canals in human mandibular or maxillary molar teeth with ProTaper. Fifty-six teeth were excluded due to unreadable image, misinformation, or straight or severe curve. Using pre- and post-preparation digital radiographs, the straightening of curved root canals was investigated. Loss of working length and incidence of fracture were also noted. A total of eighty-eight curved root canals were selected. Mesiobuccal or mesiolingual roots with curvatures of between 20° and 43° as assessed by Schneider's method and working length of between 15 mm and 22.5 mm were included in the study. The means of the curved root canals before and after the instrumentation were 29.5° ± 6° and 27° ± 6.3°, respectively. The means of the working length before and after the instrumentation were 19 mm ± 2.1 mm and 18.3 mm ± 1.9 mm, respectively. A statistically significant difference between straightening of curved root canals and loss of working length was found between before and after instrumentation (p<0.000). The mean straightening of curved root canals and loss of working length after preparation with the size F1 ProTaper file were 2.5 mm ± 3.6 mm and 0.7 mm ± 0.6 mm, respectively. Only two F1 ProTaper instruments fractured at the apical level. The study concluded that rotary instruments performed adequately with inexperienced operators who received a brief structured training session.