Effect of glide path preparation on postoperative pain using TruNatomy and Reciproc Blue in single-visit root canal therapy: A randomized clinical trial

Background: This study aimed to compare the effect of glide path preparation (manual versus mechanical) on postoperative pain following single-visit root canal treatment using two NiTi file systems (TruNatomy vs. Reciproc Blue). Materials and Methods: A total of 140 asymptomatic, necrotic teeth indicated for primary root canal treatment were assigned to four equal groups ( n = 35): Group IA: TruNatomy with TruNatomy Glider, Group IB: TruNatomy with manual #10/#15 K-files, Group IIA: Reciproc Blue with R-Pilot, and Group IIB: Reciproc Blue with manual #10/#15 K-files. Pain intensity was measured using a Visual Analog Scale (VAS) at 6, 12, 24, and 48 h after treatment. Patients also recorded the number of 400 mg ibuprofen tablets taken for pain relief. Results: At the 12-h mark, rotary instrumentation (Group I) resulted in significantly higher VAS scores compared to reciprocating instrumentation (Group II) ( P = 0.033), specifically in Subgroup A (with engine-driven glide path; P = 0.033). No significant differences in pain were observed in the subgroups without a glide path. Analgesic consumption was similar across all the groups ( P > 0.05). Conclusion: Postoperative pain was comparable between rotary and reciprocating systems over a 48-h period. Reciprocating instrumentation showed slightly lower pain at 12 h. The glide path technique had no significant influence, offering flexibility in clinical practice.