Effect of Different Irrigant Activation Methods on Post-operative Pain in Patients with Symptomatic Irreversible Pulpitis- A Randomized Controlled Trial

Aim: The aim of this study is to compare the effectiveness of irrigation activation techniques on postoperative pain (PP) in mandibular premolar teeth after single-visit endodontic treatment. Methodology: Eighty patients with symptomatic irreversible pulpitis were selected. Patients were randomly allocated into four groups based on the final irrigation methods – Group I (side-vented needle), Group II (sonic activation), Group III (ultrasonic activation), and Group IV (reciprocal activation). After final irrigation protocol, obturation was done with gutta-percha points and AH Plus root canal sealer in a cold lateral condensation technique in all the groups. Postendodontic restoration was done using nanohybrid composite resin (Filtek Z350 × t, 3M ESPE, St. Paul, Minnesota, USA). Evaluation of PP was done at specific time intervals (2, 6, 24, 48, 72 h, and 7 days) after the single-visit root canal treatment. Patients were also instructed to take analgesics (ibuprofen 200 mg) if their pain scale crosses score 2 postoperatively based on Wong–Baker Faces chart. Statistical Analysis: The results were statistically analyzed by Friedman test and Mann–Whitney U -test. Results: There was a statistical significant difference in the mean PP scores among all the groups at different time intervals ( P < 0.05). Group III resulted in significantly less PP and analgesic than all the other groups in the first 24 h. Conclusion: Ultrasonic activation (Group III) showed least PP and analgesics intake than all the other groups.