Restor Dent Endod.  2017 May;42(2):140-145. 10.5395/rde.2017.42.2.140.

Intraoperative discomfort associated with the use of a rotary or reciprocating system: a prospective randomized clinical trial

• Gomes AC
• Soares AJ
• Souza EM
• Zaia AA
• Silva EJ

• KMID: 2379464
• DOI: http://doi.org/10.5395/rde.2017.42.2.140

Abstract

OBJECTIVES
The aim of this randomized, controlled, prospective clinical study was to evaluate patients' intraoperative discomfort during root canal preparations in which either multi-file rotary (Mtwo) or single-file reciprocating (Reciproc) systems were used.
MATERIALS AND METHODS
Fifty-five adult patients, aged between 25 and 69 years old, with irreversible pulpitis or pulp necrosis participated in this study. Either the mesiobuccal or the distobuccal canals for maxillary molars and either the mesiobuccal or the mesiolingual canals for mandibular molars were randomly chosen to be instrumented with Mtwo multi-file rotary or Reciproc single-file reciprocating systems. Immediately after each canal instrumentation under anesthesia, patient discomfort was assessed using a 1 - 10 visual analog scale (VAS), ranging from "˜least possible discomfort' (1) to "˜greatest possible discomfort' (10). The Wilcoxon signed-rank test was used to determine significant differences at p< 0.05.
RESULTS
Little intraoperative discomfort was found in all cases. No statistically significant differences in intraoperative discomfort between the 2 systems were found (p = 0.660).
CONCLUSIONS
Root canal preparation with multi-file rotary or single-file reciprocating systems had similar and minimal effects on patients' intraoperative discomfort.

Keyword

Endodontics; Instrumentation; Pain

MeSH Terms

Adult
Anesthesia
Clinical Study
Dental Pulp Necrosis
Endodontics
Humans
Molar
Prospective Studies*
Pulpitis
Root Canal Preparation
Visual Analog Scale

Figure

• 

  Figure 1 CONSORT flow diagram for randomized clinical trials. Mtwo, multi-file rotary; Reciproc, single-file reciprocating.

Reference

1. Yared G. Canal preparation using only one NiTi rotary instrument: preliminary observations. Int Endod J. 2008; 41:339–344. PMID: 18081803.

2. Lopes HP, Elias CN, Vieira MV, Siqueira JF Jr, Mangelli M, Lopes WS, Vieira VT, Alves FR, Oliveira JC, Soares TG. Fatigue life of Reciproc and Mtwo instruments subjected to static and dynamic tests. J Endod. 2013; 39:693–696. PMID: 23611393.

3. da Frota MF, Espir CG, Berbert FL, Marques AA, Sponchiado-Junior EC, Tanomaru-Filho M, Garcia LF, Bonetti-Filho I. Comparison of cyclic fatigue and torsional resistance in reciprocating single-file systems and continuous rotary instrumentation systems. J Oral Sci. 2014; 56:269–275. PMID: 25500924.

4. Kiefner P, Ban M, De-Deus G. Is the reciprocating movement per se able to improve the cyclic fatigue resistance of instruments? Int Endod J. 2014; 47:430–436. PMID: 24033466.

5. Plotino G, Grande NM, Porciani PF. Deformation and fracture incidence Reciproc instruments: a clinical evaluation. Int Endod J. 2015; 48:199–205. PMID: 24754602.

6. Zuolo ML, Carvalho MC, De-Deus G. Negotiability of second mesiobuccal canals in maxillary molars using a reciprocating system. J Endod. 2015; 41:1913–1917. PMID: 26443438.

7. Dincer AN, Er O, Canakci BC. Evaluation of apically extruded debris during root canal retreatment with several NiTi systems. Int Endod J. 2015; 48:1194–1198. PMID: 25557631.

8. Fidler A. Kinematics of 2 reciprocating endodontic motors: the difference between actual and set values. J Endod. 2014; 40:990–994. PMID: 24935550.

9. Relvas JB, Bastos MM, Marques AA, Garrido AD, Sponchiado EC Jr. Assessment of postoperative pain after reciprocating or rotary NiTi instrumentation root canals: a randomized, controlled clinical trial. Clin Oral Investig. 2016; 20:1987–1993.

10. Kherlakian D, Cunha RS, Ehrhardt IC, Zuolo ML, Kishen A, Da Silveira Bueno CE. Comparison of the incidence of postoperative pain after using 2 reciprocating systems and a continuous rotary system: a prospective randomized clinical trial. J Endod. 2016; 42:171–176. PMID: 26614017.

11. Martín-González J, Echevarría-Pérez M, Sánchez-Domínguez B, Tarilonte-Delgado ML, Castellanos-Cosano L, López-Frías FJ, Segura-Egea JJ. Influence of root canal instrumentation and obturation techniques on intra-operative pain during endodontic therapy. Med Oral Patol Oral Cir Bucal. 2012; 17:e912–e918. PMID: 22549694.

12. Law AS, Nixdorf DR, Aguirre AM, Reams GJ, Tortomasi AJ, Manne BD, Harris DR. National Dental PBRN Collaborative Group. Predicting severe pain after root canal therapy in the National Dental PBRN. J Dent Res. 2015; 94:37S–43S. PMID: 25355775.

13. Pasqualini D, Mollo L, Scotti N, Cantatore G, Castellucci A, Migliaretti G, Berutti E. Postoperative pain after manual and mechanical glide path: a randomized clinical trial. J Endod. 2012; 38:32–36. PMID: 22152616.

14. Mehrvarzfar P, Abbott PV, Saghiri MA, Delvarani A, Asgar K, Lotfi M, Karamifar K, Kharazifard MJ, Khabazi H. Effects of three oral analgesics on postoperative pain following root canal preparation: a controlled clinical trial. Int Endod J. 2012; 45:76–82. PMID: 21902704.

15. Gambarini G, Testarelli L, De Luca M, Milana V, Plotino G, Grande NM, Rubini AG, Al Sudani D, Sannino G. The influence of three different instrumentation techniques on the incidence of postoperative pain after endodontic treatment. Ann Stomatol (Roma). 2013; 4:152–155. PMID: 23741536.

16. Silva EJ, Menaged K, Ajuz N, Monteiro MR, Coutinho-Filho TS. Postoperative pain after foraminal enlargement in anterior teeth with necrosis and apical periodontitis: a prospective and randomized clinical trial. J Endod. 2013; 39:173–176. PMID: 23321226.

17. Singh RD, Khatter R, Bal RK, Bal CS. Intracanal medications versus placebo in reducing postoperative endodontic pain: a double-blind randomized clinical trial. Braz Dent J. 2013; 24:25–29. PMID: 23657409.

18. Caviedes-Bucheli J, Moreno JO, Carreño CP, Delgado R, Garcia DJ, Solano J, Diaz E, Munoz HR. The effect of single-file reciprocating systems on substance P and calcitonin gene-related peptide expression in human periodontal ligament. Int Endod J. 2013; 46:419–426. PMID: 23062064.

19. Nekoofar MH, Sheykhrezae MS, Meraji N, Jamee A, Shirvani A, Jamee J, Dummer PM. Comparison of the effect of root canal preparation by using Waveone and Protaper on postoperative pain: a randomized clinical trial. J Endod. 2015; 41:575–578. PMID: 25720984.