Reduction of Post-endodontic Pain After RCT When Intracanal Cryotherapy is Used.
Condition: Post Operative Pain
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      The goal of this research was to relate the occurrence of post-endodontic pain after
      single-visit RCT using Balanced Force technique and two reciprocating system when cryotherapy
      is used. Methodology: All 216 patients had upper or lower molar, premolar or anterior teeth
      selected for conventional RCT for prosthetic reasons detected with only vital pulps. Of the
      sample of 216 teeth, were selected to the 3 instrumentation methods. For hand
      instrumentation, Balanced Force were used. All canals were clean and shaped with hand Flex-R
      files (fMoyco/Union Broach, York PA, USA). For mechanical shaping, all instruments were used
      with a micro motor (VDW, Munich Germany). WaveOne and Reciproc instruments. Final irrigation
      with cold (6oC) 17% EDTA served as a lubricant.
    

Detailed description: 
      Patient selection Two hundred and sixteen of 245 patients (119 women and 97 men) aged 18-65
      years were incorporated in this research while 29 were excluded as not meeting the inclusion
      criteria. (Fig. 1). Sample size estimate was achieved according with a method for this
      specific purpose (Cochran's method, 1986). Therefore, the 56 teeth allocated to each group
      were adequate to confirm an essential sample size.

      For hand instrumentation, the Balanced Force technique was used. All root canals were shaped
      with hand Flex-R files (Moyco/Union Broach, York PA, USA). Gates-Glidden drills (Dentsply
      Maillefer) sizes #2 and #3 were used at the orifice of the root canals. For mechanical
      preparations, all instruments were used with a micro motor (VDW Silver Motor, VDW, Munich
      Germany). Torque and rotation were preset for each Reciproc or WaveOne instrument. Rotary
      Ni-Ti instruments were used in continuous brushing rotary motion and reciprocating mode
      respectively.

      Dentinal debris was eliminated from the file with a gauze, instantaneously to the instrument
      change (WaveOne) or after 2-3 in-and-out (pecking) movements (Reciproc) following the
      manufacturers' recommendations. Each root canal was irrigated with 2.5mL 2.6% NaOCl.
      Irrigation was performed using a 24-gauge needle (Max-I-Probe; Tulsa Dental, York, PA) and a
      31-G NaviTip needle (Ultradent Products Inc, South Jordan, UT) when reaching the WL after
      each instrument insertion.

      Group BF. For the Balanced Force group, the root canals were shaped and shaped using a #40
      instrument for thin or curved canals and a #55 file for wide canals.

      Group WON. For the WaveOne group, a file size 25/.08 was used to prepare narrow, straight and
      curved canals, and a file size 40/.08 was used for large and wide canals.

      Three in-and-out pecking motions were used with an amplitude of not more than 3 mm until
      reaching the estimated working length.

      Group REC. The R25 (size 25/ .08) instrument was used in thin and curved root canals, and R40
      files (40/ .06) were used in wide root canals. Three in-and-out pecking motions were used
      with an amplitude of not more than 3 mm until reaching the estimated working length.
    

Intervention name(s): Balanced Force technique; WaveOne technique; Reciproc technique
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): Flex-R files sizes 15-45 taper .02 were used according to the technique on each tooth; WaveOne instrument was used to prepare narrow, straight and curved canals, and file (40.08) was used for large canals.
Three in-and-out motions were used with lengths not beyond 3 mm in the three thirds of the canal until reaching the estimated WL.; Reciproc files were used in wide canals. Three in-and-out motions were used with lengths not beyond 3 mm in the three thirds of the canal until reaching the estimated WL.
Allocation: Randomized
Intervention model: Factorial Assignment
Intervention model description: Random Selection of instrumentation groups. Of the sample of 216 teeth, 72 were randomly assigned to the one of the 3 instrumentation methods. Treatment was performed by 3 experienced endodontists; each prepared 72 teeth, 24 per technique.
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: pain; post endodontic pain; root canal treatment