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Abstract
Objective: To compare the effects of conventional and sonic irrigation on postoperative pain during root canal treatment.
Methodology: A randomised clinical trial was conducted at the Department of Operative Dentistry and Endodontics at HITEC-IMS Taxila. Eighty-two patients were randomly selected and assigned equally to two groups (n = 41 each) using a lottery method. Postoperative pain was assessed using the visual analogue scale, and analgesic intake was recorded at 6, 12, 24, and 48 h. Mean VAS scores and mean analgesic intake between groups were compared using the independent-samples t-test, with significance set at P < 0.05.
Results: Patients treated with sonic irrigation reported lower postoperative pain than those treated with needle irrigation at all evaluated time points. At 6 h, 65.9% of patients in the sonic irrigation group had mild pain, and 17.1% were pain-free, whereas 61% of patients in the needle irrigation group had moderate pain and 17.1% had severe pain. At 12 to 24 h, 85.4% of patients in the sonic irrigation group were pain-free, whereas 41.5% in the needle irrigation group still had moderate pain. By 48 hours, 90.2% of the patients in the sonic irrigation group were pain-free.
Conclusion: Sonic irrigation significantly reduced postoperative pain and analgesic intake compared to conventional needle irrigation.
Keywords: Analgesics, Endodontics, Postoperative Pain, Root Canal Irrigation, Dental Pulp Disease, Pain Measurement, Sodium Hypochlorite
References
Karamifar K, Tondari A, Saghiri MA. Endodontic postoperative pain: A comprehensive review. Iran Endod J. 2020;15(1):1-9. https://doi.org/10.32067/GIE.2021.35.02.38
Lottanti S, Simon JC, Bode P, Zehnder M. A comparative evaluation of the cleaning efficacy of a modified self-adjusting file and passive ultrasonic irrigation in moderately curved root canals. Clin Oral Investig. https://doi.org/10.4012/dmj.2013-106
Topçuoğlu HS, Topçuoğlu G, Arslan H. The effect of apical positive and negative pressure irrigation methods on postoperative pain in mandibular molar teeth with symptomatic irreversible pulpitis: A randomized clinical trial. J Endod. 2018;44(8):1210-1215. https://doi.org/10.1016/j.joen.2018.04.019
Azim AA, Aksel H, Zhuang T, Mashtare T, Babu JP, Huang GTJ, et al. Efficacy of two irrigation protocols in reducing bacterial load in oval canals: An in vivo study. Int Endod J. 2020;53(11):1625-1637. https://doi.org/10.1111/iej.13396
Mozo S, Llena C, Forner L. Review of ultrasonic irrigation in endodontics: Increasing action of irrigating solutions. Med Oral Patol Oral Cir Bucal. 2012;17(3):e512-e516. https://doi.org/10.4317/medoral.17621
Alkahtani A, Al Sabri FA, Almalki FA, Alqarni MS, Alhaddad AJ, Jamleh A., et al Postoperative pain intensity after using sonic, ultrasonic, and laser irrigation: A randomized controlled clinical trial. Materials (Basel). 2022;15(9):3102. https://doi.org/10.3390/ma15093102
ElAfify NA, Hashem AA, Kamel WH, Abdel Hafiz E. The influence of three root canal irrigation methods on postoperative pain: Randomized clinical trial. Future Dent J. 2021;7(2):79-83. https://doi.org/10.54623/fdj.7021
Gündoğar M, Sezgin GP, Kaplan SS, Özyürek H, Uslu G, Özyürek T, et al. Postoperative pain after different irrigation activation techniques: A randomized clinical trial. Odontology. 2021;109(2):385-392. https://doi.org/10.1007/s10266-020-00553-5
Pirzado S, Abidi SYA, Lone MM, Adnan S, Sajjad I, Ahmed J, et al. Comparison of postoperative pain using Endo-Activator vs conventional irrigation in symptomatic periapical periodontitis: A randomized controlled trial. J Coll Physicians Surg Pak. 2025;35(7):830-836. https://doi.org/10.29271/jcpsp.2025.07.830
Numan A, Muazzam A. Conception of adulthood among Pakistani emerging adults. Int Rev Basic Appl Sci. 2023;11(4):13-19. https://doi.org/10.1007/s10804-024-09493-8
Sadaf D, Ahmad MZ. Factors associated with postoperative pain in endodontic therapy. Int J Biomed Sci. 2014 Dec;10(4):243-7. PMID: 25598754; PMCID: PMC4289697
Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR, et al. Review of contemporary irrigant agitation techniques and devices. J Endod. 2009;35(6):791-804. https://doi.org/10.1016/j.joen.2009.03.010
Baba NZ, Baroudi K. Evaluation of pain perception using verbal rating scale after root canal treatment. J Clin Diagn Res. 2016;10(5):ZC50-ZC53. https://doi.org/10.7860/JCDR/2016/19433.7821
Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs. 1988 Jan-Feb;14(1):9-17. PMID: 3344163
Silva EJNL, Machado R, Belladonna FG, Souza EM, Neves AA, Alves FRF, et al. Effect of continuous ultrasonic irrigation on postoperative pain: A randomized controlled clinical trial. J Endod. 2018;44(3):332-337. https://doi.org/10.1016/j.joen.2017.10.009
Pawar AM, Pawar M, Pawar AS. Effectiveness of needle irrigation and EndoActivator on postoperative pain after root canal treatment: A randomized controlled trial. J Conserv Dent. 2020;23(3):293-297. https://doi.org/10.4103/JCD.JCD_477_19
Ramamoorthi S, Nivedhitha MS, Divyanand MJ. Comparative evaluation of postoperative pain after using an endodontic needle and EndoActivator during root canal irrigation: A randomized controlled trial. Aust Endod J. 2015;41(2):78-87. https://doi.org/10.1111/aej.12076
Sidharath, Khokhar SA, Ejaz S, Madiha, Khowaja AA, Kumar R, et al. Evaluation of postoperative pain with EndoActivator and conventional syringe irrigation in single rooted teeth. Pak J Health Sci. 2023;4(5):149-153. ttps://doi.org/10.54393/pjhs.v4i05.775
Erkan E, Gündoğar M, Uslu G, et al. Postoperative pain after SWEEPS, PIPS, sonic and ultrasonic-assisted irrigation activation techniques: A randomized clinical trial. Odontology. 2022;110(4):786-794. https://doi.org/10.1007/s10266-022-00700-0
Yılmaz K, Tufenkci P, Adıgüzel M. The effects of QMix and EndoActivator on postoperative pain in mandibular molars with nonvital pulps: A randomized clinical trial. Clin Oral Investig. 2019;23(11):4315-4321. https://doi.org/10.1007/s00784-019-02988-0
Koçak MM, Koçak S, Er K. Comparison of different irrigation activation techniques on postoperative pain: A randomized controlled trial. Turk Endod J. 2025;7(1):12-18. https://doi.org/10.4103/tej.tej_34_24.
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