Post-operative Pain in Single and Multi-visits Root Canal Treatment

Abstract

The purpose of this prospective, descriptive and analytical study is to evaluate any association of postoperative pain after RCT with various clinical factors or conditions in the Department of Conservative Dentistry, Faculty of Dentistry, University of Khartoum. Further prospective studies and randomized clinical trials are needed to assess these factors, which may achieve a higher level of support for evidenced based clinical practice. Two hundred and thirty four patients were included in the study, age range was 18-62 years. Demographic, medical history and dental history was recorded. These included: the tooth type and location in the arch, periapical condition, and pulpal vitality based on pulp testing and direct clinical observation, history of preoperative pain and number of root canal treatment visits. Conventional endodontic treatment was carried out in the included teeth by the undergraduate dental students in a single-visit or multi-visits. RCT is completed and obturated in a single-visit if the operator was able to complete chemomechanical preparation and maintain dry canals. The chemomechanical preparation of root canals was done by a modified double flared technique using combination of hand instruments. Naocl 2.5% was used as an irrigating solution and Calcium hydroxide as an intracanal medicament in cases of multi-visits. Postoperative pain was recorded by each patient using Visual Analogue Scale (VAS) in well defined categories at two time intervals 12 hours and 24 hours. Data were analyzed using chi-square test. The overall incidence of postoperative pain was 9.0% after 12hours and 24 hours. 15.9% of the patients with history of preoperative pain developed III postoperative pain, while 7.1% had postoperative pain among those without history of preoperative pain. This difference was significant. In patients with non-vital teeth 13.7% had postoperative pain, while it was only 7% in those with vital teeth. The difference was significant. (p< 0.05). There was no significant difference in the incidence of postoperative pain in relation to gender, tooth type/position, periapical status of the treated teeth and number of visits. The incidence of postoperative pain in single-visit was 9.4% and in multi-visits was 11.1% without significant difference. The percentage of single-visit RCT cases was 13.7% and multi-visits was 86.3%. Within the limitations of this study it could be concluded that history of preoperative pain and non-vital teeth were significantly associated with postoperative pain. No significant association was found between postoperative pain in RCT and clinical factors or conditions such as age, gender and tooth type/position, periradicular status of the treated teeth and number of visits.