Acta Scientific Dental Sciences (ASDS)(ISSN: 2581-4893)

Research Article Volume 7 Issue 2

Influence of Apical Patency Concept Upon Postoperative Pain Following Single Session Primary Root Canal Treatment in Molars with Pulpal Disease

Mostafa I Negm

Department of Endodontics (Faculty of Oral and Dental Medicine), Zagazig University, Egypt

*Corresponding Author: Mostafa I Negm, Department of Endodontics (Faculty of Oral and Dental Medicine), Zagazig University, Egypt.

Received: January 25, 2023; Published: February 06, 2023


This clinical investigation examined the effect of implementing the apical patency concept on postoperative pain following root canal treatment in a single session approach for molars with irreversible pulpal pathology and healthy periodontium. Thirty-two patients, ranging in age from 18 to 60 years, were divided into two groups: group I with implementation of the apical patency concept and group II without implementation of the apical patency concept. The primary end measure was postoperative pain, which was quantified using the Visual Analogue Scale (VAS) at four, six, twelve, twenty-four, and forty-eight hours after root canal procedure. Consumption of analgesics was a side effect. Pain alleviation occurred more rapidly in group I than in group II. The two groups did not differ statistically substantially in terms of analgesic pill intake (P-value = 0.654). Maintaining apical patency during a single session of root canal therapy is associated with decreased postoperative discomfort.

Keywords: Postoperative Pain; Single Session; Root Canal Treatment; Pulpal Diseases; Patency


    1. Javier Caviedes-Bucheli., et al. “Neuropeptides in Dental Pulp: The Silent Protagonists”. Journal of Endodontics 34 (2008): 773-788.
    2. Sathorn C., et al. “The prevalence of postoperative pain and flare-up in single-and multiple-visit endodontic treatment: a systematic review”. International Endodontic Journal 41 (2008): 91-99.
    3. Bergenholtz G and Spangberg L. “Controversies in endodontics”. Critical Reviews in Oral Biology and Medicine 15 (2004): 99-114.
    4. Schilder H. “Cleaning and shaping the root canal”. Dental Clinics of North America 18 (1974): 269-296.
    5. Bellamy R. “Confine yourself to the canal”. Irish Dentist 13 (2003): 10-11.
    6. Souza R. “The importance of apical patency and cleaning of the apical foramen on root canal preparation”. Brazilian Dental Journal 17 (2006): 6-9.
    7. Hulsmann Michael and Schafer Eadger. “Apical patency: Fact and fiction-a myth or a must? A contribution to the discussion”. Endodontic (London England) 3 (2009): 285-307.
    8. American Association of Endodontists: Glossary of Endodontic Terms. 7th edition., Chicago, IL, USA (2003).
    9. Cailleteau JG and Mullaney TP. “Prevalence of teaching apical patency and various instrumentation and obturation techniques in United States dental schools”. Journal of Endodontics 23 (1997): 394-396.
    10. Buchanan LS. “Management of the curved root canal”. Journal of the California Dental Association 17 (1989): 19-27.
    11. Bellamy R. “The art of patency”. Endodontic Practice 9 (2006): 9-12.
    12. Ruddle CJ. “Cleaning and shaping the root canal system”. In: Cohen S, Burns R (ed.). Pathways of the Pulp, edition 8. St. Louis: Mosby (2002): 244-277.
    13. Siqueira JF. “Reaction of periradicular tissues to root canal treatment: benefits and drawbacks”. Endodontic Topics 10 (2005): 123-147.
    14. Cohen S and Burns R. “Pathways of the Pulp, edition 6. St. Louis: Mosby (1994).
    15. Arias A., et al. “Relationship between postendodontic pain, tooth diagnostic factors, and apical patency”. Journal of Endodontics 35 (2009): 189-192.
    16. Arora M., et al. “Effect of maintaining apical patency on endodontic pain in posterior teeth with pulp necrosis and apical periodontitis: a randomized controlled trial”. International Endodontic Journal 49 (2016): 317-324.
    17. Yaylali IE., et al. “Maintaining Apical Patency Does Not Increase Postoperative Pain in Molars with Necrotic Pulp and Apical Periodontitis: A Randomized Controlled Trial”. Journal of Endodontics 44 (2018): 335-340.
    18. Eleazer PD and Eleazer KR. “Flare-Up Rate in Pulpally Necrotic Molars in One Visit Versus Two-Visit Endodontic Treatment”. Journal of Endodontics 24 (1998): 614-616.
    19. Walton R and Fouad A. “Endodontic interappointment flare-ups: a prospective study of incidence and related factors”. Journal of Endodontics 18 (1992): 172-177.
    20. Jensen MP., et al. “Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain”. Journal of Pain 4 (2003): 407-414.
    21. Jensen MP., et al. “The measurement of clinical pain intensity: a comparison of six methods”. Pain 27 (1986): 117-126.
    22. 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.
    23. Oliet S. “Single-visit Endodontics: A Clinical Study”. Journal of Endodontics 9 (1983): 147-152.
    24. El Mubarak AH., et al. “Postoperative Pain in Multiple-visit and Single-visit Root Canal Treatment”. Journal of Endodontics 36 (2010): 36-39.
    25. Pak JG and White SN. “Pain prevalence and severity before, during, and after root canal treatment: a systematic review”. Journal of Endodontics 37 (2011): 429-438.
    26. Nagendrababu V and Gutmann JL. “Factors associated with postobturation pain following single-visit nonsurgical root canal treatment: a systematic review”. Quintessence International 48 (2017): 193-208.
    27. Arias A., et al. “Predictive models of pain following root canal treatment: a prospective clinical study”. International Endodontic Journal 46 (2013): 784-793.
    28. Comparin D., et al. “Postoperative Pain after Endodontic Retreatment Using Rotary or Reciprocating Instruments: A Randomized Clinical Trial”. Journal of Endodontics 43 (2017): 1084-1088.
    29. Jorge NR Martins., et al. “Clinical Efficacy of Electronic Apex Locators: Systematic Review”. Journal of Endodontics 40 (2014): 759-777.
    30. Castellucci A. Endodontics 2 (2003): 2004-20a42.
    31. Plotino G., et al. “Ex vivo accuracy of three electronic apex locators: Root ZX, Elements Diagnostic Unit and Apex Locator and ProPex”. International Endodontic Journal 39 (2006): 408-414.
    32. Green D. “Stereo-binocular microscopic study of the root apices and surrounding areas of 100 mandibular molars”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 8 (1955): 1298-304.
    33. Martos J., et al. “Topographical evaluation of the major apical foramen in permanent human teeth”. International Endodontic Journal 42 (2009): 329-334.
    34. Williams CB., et al. “A comparison between in vivo radiographic working length determination and measurement after extraction”. Journal of Endodontics 32 (2006): 624-627.
    35. Baumgartner JC., et al. “The incidence of bacteremias related to endodontic procedures. I. Nonsurgical endodontics”. Journal of Endodontics 2 (1976): 135-140.
    36. Christopher Beus., et al. “Comparison of the Effect of Two Endodontic Irrigation Protocols on the Elimination of Bacteria from Root Canal System: A Prospective, Randomized Clinical Trial”. Journal of Endodontics 38 (2012): 1479-1483.
    37. Goldberg F and Masson E. “Patency file and apical transportation: an in vitro study”. Journal of Endodontics 28 (2003): 510-511.
    38. Abdulrab S., et al. “Effect of Apical Patency on Postoperative Pain: A Meta-analysis”. Journal of Endodontics 44 (2018): 1467-1473.
    39. Jacinto RC., et al. “Quantification of endotoxins in necrotic root canals from symptomatic and asymptomatic teeth”. Journal of Medical Microbiology 54 (2005): 777-783. 
    40. Seltzer S. “Pain in Endodontics”. Journal of Endodontics 12 (1986): 505-508.
    41. Vera J., et al. “Effect of maintaining apical patency on irrigant penetration into the apical two millimeters of large root canals: an in vivo study”. Journal of Endodontics 38 (2012): 1340-1343.
    42. Kamra AI., et al. “Effect of maintaining apical patency and passive ultrasonic irrigation on irritant penetration into the apical third of root canals: an in vivo study”. Endodontology 28 (2016): 127.
    43. Parolia A., et al. “Role of cytokines, endotoxins (LPS), and lipoteichoic acid (LTA) in endodontic infection”. Journal of Dental Health, Oral Disorders and Therapy 2 (2014):1-5.
    44. Siqueira JF. “Microbial causes of endodontic flare-ups". International Endodontic Journal 36 (2003): 453-463.
    45. Barry J Sessle. “Recent Developments in Pain Research: Central Mechanisms of Orofacial Pain and Its Control”. Journal of Endodontics 12 (1986): 435-443.


    Citation: Mostafa I Negm. “Influence of Apical Patency Concept Upon Postoperative Pain Following Single Session Primary Root Canal Treatment in Molars with Pulpal Disease".Acta Scientific Dental Sciences 7.3 (2023): 11-20.


    Copyright: © 2023 Mostafa I Negm. 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.


Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.278

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is April 30th, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US