World Journal of Dentistry

Register      Login

VOLUME 13 , ISSUE 5 ( September-October, 2022 ) > List of Articles


A Clinical Evaluation of Postoperative Pain with and without the Maintenance of Apical Patency in Single Sitting Root Canal Treatment

Sumita Bhagwat, Namrata Vikmani, Leena Padhye

Keywords : Apical patency, Postoperative pain, Single sitting root canal treatment

Citation Information : Bhagwat S, Vikmani N, Padhye L. A Clinical Evaluation of Postoperative Pain with and without the Maintenance of Apical Patency in Single Sitting Root Canal Treatment. World J Dent 2022; 13 (5):508-512.

DOI: 10.5005/jp-journals-10015-2108

License: CC BY-NC 4.0

Published Online: 22-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aims: The aim of the study was to assess whether maintenance of apical patency during instrumentation leads to altered postoperative pain in single-visit root canal treatment (RCT) as compared to non-maintenance of apical patency. Materials and methods: A total of 60 patients with symptomatic irreversible pulpitis in vital permanent mandibular molars were selected to be included in the study. The patients were randomly divided into two groups: group A, where apical patency was maintained and group B, where it was not maintained. The root canal procedures for the patients were carried out in single sitting under a rubber dam using E3 Azure (Endostar, Poland) rotary system, 2.5% sodium hypochlorite (NaOCl) as irrigant alternating with saline, and obturation by lateral compaction technique. A questionnaire employing visual analog scale (VAS) for pain assessment was given to the patient, and instructions on how to fill the form were given. The patients were recalled after 7 days, and the pain was analyzed. The result was tabulated and statistically analyzed. Results: There was no statistical difference in the postoperative pain between the groups where apical patency was maintained vs where apical patency was not maintained. Conclusion: Based on our findings and, in comparison with those of other studies, we conclude that there is no difference in postoperative pain when there is maintenance of apical patency vs non-maintenance of apical patency in permanent mandibular molars with vital pulps treated with single sitting root canals. Clinical significance: Achieving apical patency may not be mandatory for all cases of endodontics with respect to the goal of reduction in postoperative pain.

PDF Share
  1. Bhagwat SA, Patel A, Mandke LP. The effect of variation in inter-appointment time on the incidence of post-operative pain in single-visit versus two visit endodontics: an in vivo study. J Int Clin Dent Res Organ 2012;4(1):9–17. DOI: 10.4103/2231-0754.131371
  2. Bhagwat S, Sheth N, Padhye L. Preliminary in vivo investigation into the relationship between canal preparation protocol and incidence of postoperative pain in single-visit and two-visit endodontic therapy: a randomized controlled clinical trial. J Contemp Dent 2017;7(1):48–52. DOI: 10.5005/jp-journals-10031-1184
  3. Bhagwat SA, Heredia A, Padhye LV. An in vivo double-blind randomized controlled study comparing the postoperative pain in single sitting root canal treatment under bupivacaine versus lignocaine used as a local anesthetic agent. Endodontology 2019;31(1):2–8. DOI: 10.4103/endo.endo_1_18
  4. Bergenholtz G, Spångberg L. Controversies in endodontics. Crit Rev Oral Biol Med 2004;15(2):99–114. DOI: 10.1177/154411130401500204
  5. Siqueira JF. Reaction of periradicular tissues to root canal treatment: benefits and drawbacks. Endodontic Topics 2005;10(1):123–147. DOI: 10.1111/j.1601-1546.2005.00134.x
  6. Mounce R. What is apical patency and does it matter? Compend Contin Educ Dent 2005;26(1):62–64. PMID: 15948511.
  7. Heft MW, Parker SR. An experimental basis for revising the graphic rating scale for pain. Pain 1984;19(2):153–161. DOI: 10.1016/0304-0359(84)90835-2
  8. Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in a single- and multiple-visit endodontic treatment: a systematic review. Int Endod J 2008;41(2):91–99. DOI: 10.1111/j.1365-2591.2007.01316.x
  9. Bhagwat S, Mehta D. Incidence of post-operative pain following single visit endodontics in vital and non-vital teeth: an in vivo study. Contemp Clin Dent 2013;4(3):295–302. DOI: 10.4103/0976-237X.118352
  10. Chaudhari AK, Asthana GE, Parmar GI, et al. Significant of apical third: a review. Sch J Appl Med Sci 2014;2(5B):1613–1617. ISSN 2320-6691 (Online). ISSN 2347-954X (Print).
  11. Garg N, Sharma S, Chhabra A, et al. Clinical evaluation of maintenance of apical patency in postendodontic pain: an in vivo study. Endodontology 2017;29(2):115–119. DOI: 10.4103/endo.endo_28_17
  12. Sharaan ME, Aboul-Enein NM. Relationship between post-preparation pain and apical patency: a randomized clinical trial. GMJ 2012;1(S1):S96–S101.
  13. Arias A, de la Macorra JC, Hidalgo JJ, et al. Predictive models of pain following root canal treatment: a prospective clinical study. Int Endod J 2013;46(8):784–793. DOI: 10.1111/iej.12059
  14. Arora M, Sangwan P, Tewari S, et al. Effect of maintaining apical patency on endodontic pain in posterior teeth with pulp necrosis and apical periodontitis: a randomized controlled trial. Int Endod J 2016;49(4):317–324. DOI: 10.1111/iej.12457
  15. Yaylali IE, Kurnaz S, Tunca YM. Maintaining apical patency does not increase postoperative pain in molars with necrotic pulp and apical periodontitis: a randomized controlled trial. J Endod 2018;44(3): 335–340. DOI: 10.1016/j.joen.2017.11.013
  16. Singh S, Garg A. Incidence of post-operative pain after single visit and multiple visit root canal treatment: a randomized controlled trial. J Conserv Dent 2012;15(4):323–327. DOI: 10.4103/0 972-0707.101888
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.