Effects of sonic irrigation activation on postoperative pain following root canal treatment of teeth with apical periodontitis

Abstract

Aim: To evaluate postoperative pain of teeth with apical periodontitis after sonic irrigation activation.

Methodology: One hundred five asymptomatic patients with periapical lesions were included in this study. After chemomechanical canal preparation using rotary instruments and NaOCl, the teeth were randomly assigned to three groups (n=35 per group): control (conventional needle irrigation-CNI), manual dynamic irrigation activation (MDI), and sonic irrigation activation (SI). In each group, final irrigation was performed using 3 ml of 2.5% NaOCl and 2 ml of 17% EDTA solution, and the relevant activation method. Patients recorded their pain intensity at 24 h, 48 h, and 7 days after treatment on a modified visual analogue scale (VAS), as well as their analgesic consumption. Demographic data and pain levels were compared across groups using Fisher’s Exact and one-way ANOVA tests, with differences of p < 0.05 considered statistically significant.

Results: There was a significant increase in pain levels at 24 and 48 hours postoperatively, and no difference was found between the groups (p = 0.1464 and p = 0.0655, respectively). At day 7 postoperatively, pain intensity and incidence were significantly lower in the SI group compared to the CNI and MDI groups (p = 0.0435). However, the frequency of analgesic intake did not differ significantly between the groups (p = 0.863). Furthermore, none of the methods resulted in any adverse effects.

Conclusion: The conventional needle irrigation and manual dynamic activation used in this study were associated with a similar intensity of postoperative pain in asymptomatic patients receiving primary root canal treatment. However, on the seventh day, sonically activated irrigation resulted in lower postoperative pain.