The Effect of Foraminal Enlargement of Necrotic Teeth with a Continuous Rotary System on Postoperative Pain: A Randomized Controlled Trial

Abstract

Introduction: This single-blind, randomized controlled trial aimed to evaluate whether foraminal enlargement (FE) with a continuous rotary system during endodontic treatment causes more postoperative pain than nonforaminal enlargement (NFE).

Methods: Seventy qualified patients were randomized into 1 of 2 groups in a 1:1 ratio using a series of random numbers: the FE group and the NFE group. The patients were followed up for 7 days to evaluate between-group differences in the outcome measures. The study participants were selected from among patients who had necrosis and apical periodontitis in the maxillary or mandibular molar teeth. The primary outcome was to assess postoperative pain severity, and the secondary outcome was to evaluate analgesic consumption during the follow-up period. Pain severity was evaluated for the first 7 days using a visual analog scale (VAS). The VAS consisted of a 100-mm line. Pain severity was assessed as no pain (0-4 mm), mild pain (5-44 mm), moderate pain (45-74 mm), and severe pain (75-100 mm). The quality of life of patients during the follow-up period was assessed using a quality of life scale. The Student t test was used to identify statistically significant differences between the study groups (P < .05).

Results: A significant difference was noted in postoperative pain in the first 2 days; the FE group experienced more pain than the conventional NFE group (P < .05). In the FE group, 12 and 11 patients (34% and 31%) had severe postoperative pain (VAS score, >74 mm) on the first day and second day, respectively. VAS pain scores between the groups were not different (P > .05) on other days. No significant difference was found in analgesic consumption between the groups (P > .05).

Conclusions: On the basis of the VAS results, this randomized controlled trial indicates that FE causes more pain on the first 2 days after an endodontic treatment.

Keywords: Endodontics; foraminal enlargement; postoperative pain; rotary systems.