The Effect of Solvent Usage on Post-treatment Pain

Study Overview
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Brief Summary
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No clinical evidence has been yet published regarding the comparison of postoperative pain after removal of the root canal fillings with or without solvent. The aim of this study was to evaluate the effect of combined usage of ProTaper retreatment instruments and a gutta-percha solvent, on the postoperative pain intensity after retreatment.

Detailed Description
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Scientific literature contains a few studies regarding the amount of apically extruded debris caused by solvent or solvent free use of rotary instruments. It was reported that the use of ProTaper retreatment instruments in combination with gutta-percha solvent reduced the amount of apically extruded debris compared to their solvent free use. Nevertheless,no clinical evidence has been yet published regarding the comparison of postoperative pain after removal of the root canal fillings with or without solvent. The aim of this study was to evaluate the effect of combined usage of ProTaper retreatment instruments and gutta-percha solvent, on the postoperative pain intensity after retreatment. The adult patients (18-59 ages) who referred to Department of Endodontics with a diagnose of failed root canal treatment were examined radiographically and clinically. Endodontically treated, clinically asymptomatic, single-rooted teeth with one canal exhibiting chronic periapical infection were included. A hundred cases who matched the determined criteria were selected and randomly allocated to two groups: Non-solvent Group (n=50): ProTaper retreatment instruments were used in combination with with X-Smart electric motor for the removal of root canal fillings. Solvent Group (n=50): ProTaper retreatment instruments were used with the abovementioned technique but in combination with a gutta-percha solvent

Official Title
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Postoperative Pain After Removal of Gutta-percha From Root Canals in Endodontic Retreatment Using a Solvent

Conditions
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Root Canal Infection, Pain

Intervention / Treatment
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* Procedure: Non-solvent
* Procedure: Solvent


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Systemically healthy patient who has a failed root canal treatment. Asymptomatic single rooted teeth that had an initial root canal filling diagnosed with chronic apical periodontitis. Patients agreed to parcitipate in the study Exclusion Criteria: Overfilled teeth, teeth with intraradicular posts, existence of a sinus tract, consumption of antibiotics or analgesics within one month, pregnancy, history of trauma, traumatic occlusion

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Non-solvent<br>Non-solvent use of a rotary retreatment system | Procedure: Non-solvent<br>* Root canal filling removal using ProTaper retreatment instruments. Single session retreatment procedures.<br>|
| Experimental: Solvent<br>Solvent use in combination with a rotary retreatment system | Procedure: Solvent<br>* Root canal filling removal using ProTaper retreatment instruments in combination with a gutta percha solvent. Single session retreatment procedures.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain after removal of gutta-percha with or without solvent | Pain intensity was evaluated at 24 hours after retreatment procedures. An 11-item numerical rating scale (NRS) was used to assess the pain. This NRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0 -10 integers) that best reflects the intensity of their pain. Number 0 represents 'no pain' whereas number 10 represents 'pain as bad as someone can imagine'.All patients were requested to mark a number corresponding to their average pain. | 24 hours postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain after removal of gutta-percha with or without solvent | Pain intensity was evaluated at 48 hours after retreatment procedures. An 11-item numerical rating scale (NRS) was used to assess the pain. This NRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0 -10 integers) that best reflects the intensity of their pain. Number 0 represents 'no pain' whereas number 10 represents 'pain as bad as someone can imagine' . All patients were requested to mark a number corresponding to their average pain. | 24 to 48 hours postoperatively | 
| Postoperative pain after removal of gutta-percha with or without solvent | Pain intensity was evaluated at 72 hours after retreatment procedures. An 11-item numerical rating scale (NRS) was used to assess the pain. This NRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0 -10 integers) that best reflects the intensity of their pain. Number 0 represents 'no pain' whereas number 10 represents 'pain as bad as someone can imagine'. All patients were requested to mark a number corresponding to their average pain. | 48 to 72 hours postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Postoperative pain, Debris extrusion, Filling removal, solvent