Marian Shenoda Fathy¹*, Hebatallah Mohamed Maged ELFar² and Shaimaa Ismail Gawdat³

¹Master Degree in Endodontics, Oral and Dental Medicine, Cairo University, Giza, Egypt
²Professor of Endodontics, Faculty of Dentistry, Cairo University, Giza, Egypt
³Assistant Professor of Endodontics, Faculty of Dentistry, Cairo University, Giza, Egypt

*Corresponding Author: Marian Shenoda Fathy, Master Degree in Endodontics, Oral and Dental Medicine, Cairo University, Giza, Egypt.

Received: June 28, 2021; Published: August 07, 2021

Abstract

Introduction: Evaluation of pain intensity after endodontic instrumentation and obturation after occlusal reduction in mandibular posterior teeth associated with symptomatic irreversible pulpitis and symptomatic apical periodontitis.

Aim of the Study: To assess the effect of occlusal reduction on post-operative pain after endodontic instrumentation and obturation in patients with symptomatic irreversible pulpitis and symptomatic apical periodontitis in mandibular posterior teeth in a randomized clinical trial.

Methods: Forty-four patients diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis in mandibular posterior teeth were included in this trial. Participants were randomly allocated into two equal groups. In the group A, all occlusal contacts on the functional and non-functional cusps as well as on the marginal ridges of the teeth were reduced by 2 mm, while in group B, no modification was done. Canal instrumentation was completed on the first visit using Revo-S rotary files. Post-instrumentation pain intensity was assessed at 6, 12, 24 and 48 hrs using visual analogue. Canal obturation was completed 7days later and pain was recorded at 12 and 24 hours. In case of severe postoperative pain, analgesics and placebo were prescribed to the participants.

All demographic data, post obturation radiographic findings, VAS scores and analgesic intake were statistically analyzed.

Result: Results showed that occlusal reduction has no significant difference in pain reduction at 6 hours, 12 hours, 24 hours, and 48 hours post-instrumentation and at 6 hours and 12 hours post-obturation. There was a decrease in the median VAS score through the follow up periods in the two groups with a maximum decrease at 48 hours following root canals instrumentation. There was no significant difference in incidence of analgesic intake between the two groups.

Conclusion: Within the limitations of this study, we conclude that occlusal reduction in teeth with irreversible pulpitis and with tenderness to percussion had no significant influence on postoperative pain after root canal preparation when compared with teeth with no occlusal reduction. Pain intensity gradually decreases by time following endodontic treatment.

Keywords: Apical Periodontitis; Occlusal Reduction; Pulpitis; Postoperative Pain; Randomized Clinical Trial

References

1. Sathorn C. “The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review”. International Endodontic Journal 10 (2007): 1-9.
2. Siqueira JF Jr., et al. “Incidence of postoperative pain after intracanal procedures based on an antimicrobial strategy”. Journal of Endodontics6 (2002): 457-460.
3. Zuckerman O., et al. “Flare-up during endodontic treatment: etiology and management”. Refuat Hapeh Vehashinayim 24 (2007): 19-26.
4. Pochapski MT., et al. “Effect of pretreatment dexamethasone on postendodontic pain”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 108 (2009): 790-795.
5. Jalalzadeh SM., et al. “Effect of pretreatment prednisolone on postendodontic pain: a double-blind parallel-randomized clinical trial”. Journal of Endodontics 36 (2010): 978-981.
6. Rosenberg PA. “Clinical strategies for managing endodontic pain”. Journal of Endodontics 3 (2002): 78-92.
7. Rosenberg PA., et al. “The effect of occlusal reduction on pain after endodontic instrumentation”. Journal of Endodontics 24 (1998): 492-496.
8. Moore PA and Dunsky JL. “Bupivacaine anesthesia: a clinical trial for endodontic therapy”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 55 (1983): 176-179.
9. Dunsky JL and Moore PA. “Long-acting local anesthetics: a comparison of bupivacaine and etidocaine in endodontics”. Journal of Endodontics 10 (1984): 457-460.
10. Parirokh M., et al. “Effect of bupivacaine on postoperative pain for inferior alveolar nerve block anesthesia after single-visit root canal treatment in teeth with irreversible pulpitis”. Journal of Endodontics 38 (2012): 1035-1039.
11. Jostes JL and Holland GR. “The effect of occlusal reduction after canal preparation on patient comfort”. Journal of Endodontics1 (1984): 34.
12. Sheikh H., et al. “Comparison of post- instrumentation pain in teeth during root canal treatment with or without occlusal reduction”. Pakistan Oral and Dental Journal4 (2015): 699-701.
13. Zaman H and Ahmed S. “Effect of occlusal reduction on post instrumentation pain in patients with acute irrversible pulpitis”. Pakistan Oral and Dental Journal1 (2016): 119-121.
14. Creech JL., et al. “Effect of occlusal relief on endodontic pain”. Journal of the American Dental Association 109 (1984): 64-67.
15. Parirokh M., et al. “Effect of occlusal reduction on postoperative pain in teeth with irreversible pulpitis and mild tenderness to percussion”. Journal of Endodontics1 (2013): 1-5.
16. Ashgar S., et al. “Occlusal Reduction Reduces Postoperative Pain After Endodontic Instrumentation”. Pakistan Oral and Dental Journal3 (2014): 539-542.
17. Arslan H., et al. “The effect of various occlusal reduction levels on postoperative pain in teeth with symptomatic apical periodontitis using computerized analysis: a prospective, randomized, double-blind study”. Clinical Oral Investigations4 (2016): 1-7.
18. Zeidan BM. “Evaluation the Effect of Occlusal Reduction on Postoperative Pain in Teeth with Irreversible Pulpitis and Mild Tenderness to Percussion”. Journal of Al Rafidain University College 38 (2016): 128-140.
19. Raza I., et al. “Effect of occlusal reduction on frequency of postoperative pain relief, following an endodontic instrumentation”. Pakistan Oral and Dental Journal4 (2016): 650-653.
20. Rechenberg D., et al. “Pain levels and typical symptoms of acute endodontic infections : a prospective , observational study”. BMC Oral Health1 (2016): 1-8.
21. Khan AA., et al. “Measurement of Mechanical Allodynia and Local Anesthetic Efficacy in Patients with Irreversible Pulpitis and Acute Periradicular Periodontitis”. Journal of Endodontics7 (2007): 796-799.

Citation

Citation: Marian Shenoda Fathy., et al. “Effect of Occlusal Reduction on Postoperative Pain After Endodontic Treatment in Teeth with Irreversible pulpitis and Symptomatic Apical Periodontitis: A Randomized Clinical Trial”. Acta Scientific Dental Sciences 5.9 (2021): 46-54.

Copyright

Copyright: © 2021 Marian Shenoda Fathy., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.