Postoperative Pain After Using Different Single-File Glide Path Systems
Condition: Post Operative Pain
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      This study aimed to evaluate postoperative pain intensity after glide-path preparation with
      the ProGlider (PG) and WaveOne Gold Glider (WOGG) systems in asymptomatic teeth with necrotic
      pulp and periapical lesions.Maxillary and mandibular molars with chronic apical periodontitis
      of 78 patients (age, 18-65 years) were included. The patients were randomly divided into
      three groups: control (n = 26), PG (n = 26), and WOGG (n = 26). All systems were used
      according to the manufacturer's instructions, and all root canal treatments were completed by
      a single operator within two sessions. Postoperative pain was assessed using a numerical
      rating scale (NRS) at 6, 12, 18, 24, 48, and 72 h. The intake of prescribed analgesics and
      abscess formation were also recorded.
    

Detailed description: 
      Pain after root canal treatment is an important complication encountered in endodontic
      practice, with a reported prevalence of 3%-58%. Severe pain may start even 24 to 48 h after
      treatment. Postoperative pain has a complex etiology, including treatment factors under the
      control of the clinician, microbial factors related to the contents of infected root canals,
      patient demographic factors (patient sex and age, among others), immunological factors, local
      tissue changes, and psychological factors. Debris extrusion to the periapical tissues during
      root canal instrumentation can significantly influence the incidence and intensity of
      postoperative pain. The root canal instrumentation technique may play an important role in
      the occurrence of postoperative pain as it can induce an acute inflammatory response
      following periapical extrusion of necrotic tissues, infected debris, and bacteria. Previous
      clinical trials have evaluated the effect of reciprocation and continuous rotation kinematics
      on debris extrusion and postoperative pain; however, their results are conflicting.

      The glide path is defined as a straight tunnel extending from the canal orifice to the
      physiological apical foramen. Glide-path preparation may prevent complications of root canal
      instrumentation; reduce risk of instrument failure, debris extrusion, and postoperative pain;
      and preserve root canal anatomy, thereby reducing the risk of transportation, perforation,
      and step and zip formation. Many NiTi glide-path file systems of different sizes and
      metallurgical properties have been introduced to date. Recently, a new single glide-path file
      system was introduced with the aim of reducing the number of files used and simplifying
      glide-path instrumentation.

      The effect of glide-path file systems on postoperative pain has been studied previously.
      However, to the best of investigators' knowledge, there are no data comparing PG and WOGG
      glide-path files in terms of postoperative pain in asymptomatic teeth with necrotic pulp and
      periapical lesions. Therefore, the purpose of this in vivo study was to evaluate the
      incidence and intensity of postoperative pain in asymptomatic maxillary and mandibular molars
      with necrotic pulp and periapical lesions after glide-path preparation with a stainless-steel
      K-file and PG and WOGG glide-path file systems. The null hypothesis was that there is no
      difference in the incidence and intensity of postoperative pain between glide-path
      preparation techniques.
    

Intervention name(s): Control; ProGlider; WaveOne Gold Glider
Intervention type(s): Device; Device; Device
Intervention description(s): The operator prepared the glide path using a #15K-type stainless-steel hand file.; The operator prepared the glide path using the ProGlider file.; The operator prepared the glide path using the WaveOne Gold Glider file.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Group 1: control Group 2: ProGlider Group 3: WaveOne Gold Glider
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: chronic apical periodontitis; glide path preparation; Postoperative pain; ProGlider; WaveOne Gold Glider