The Effects of Sonic Activation of the Irrigation Solution on Postoperative Pain

Year 2024, , 125 - 132, 31.08.2024

Duygu Bilgili

https://doi.org/10.34084/bshr.1512256

Abstract

Objective: The aim of this study was to assess and compare the Vibringe Sonic Irrigation System and conventional irrigation (bevel open-ended) in terms of postoperative pain.
Methods: Ninety asymptomatic, nonvital, single-rooted and single-canal teeth were evaluated for present clinical study. The included teeth were separated into two treatment groups [Group 1: Conventional irrigation, control (pink card), Group 2: Vibringe (blue card)] via cards selected by the patients. After treatment, all participants were given a verbal descriptor scale for the assessment of the pain and taken analgesics at the 6th, 12th, 24th, and 72nd hours.
Results: Although there was no significant difference in the number of teeth with pain between the groups at the 6th, 24th, and 72nd hours, there was statistically more teeth with pain in group 2 in the 12th hour evaluation. However, in group 1, pain severity was significantly less than group 2 at all time periods.
Conclusion: The outcome of this study denotes that the use of the Vibringe may cause an increase in the postoperative pain in comparison to conventional irrigation for asymptomatic teeth.

Keywords

Root canal therapy, disinfection, postoperative pain

Ethical Statement

This prospective single-blind, controlled clinical study was conducted with the permission of the Republic of Turkey Ministry of Health Turkish Medicines and Medical Devices Acency [protocol number 71146310 (2013-AC-CE-49)] and approval of Ethics Committee of Çukurova University for Clinical Research.

Supporting Institution

This research was supported by Çukurova University Scientific Research Projects Unit (DHF2013LTP1).

Project Number

DHF2013LTP1

Thanks

(This study was produced from the author's own thesis. https://tez.yok.gov.tr/UlusalTezMerkezi/ Name of thesis: The effects of sonic activation of the solution on postoperative pain). The author thanks thesis advisor Assoc. Prof. Şehnaz Yılmaz for their contributions to the thesis stages, from the ethical decision making stage of the thesis. Furthermore, the author thanks academic personnel of Çukurova University, Faculty of Dentistry, for the contributions of thesis stages.

Sonik Olarak Aktive Edilmiş İrrigasyon Solusyonunun Postoperatif Ağrı Üzerine Etkileri

Abstract

Amaç: Bu çalışmanın amacı, Vibringe Sonik İrrigasyon Sistemi ile geleneksel irrigasyonu (açılı ucu açık) postoperatif ağrı bakımından değerlendirmek ve karşılaştırmaktır.
Yöntem: Asemptomatik, nonvital, tek köklü ve tek kanallı olan doksan diş bu klinik çalışma için değerlendirmeye alınmıştır. Dahil edilen dişler, hastalara seçtirilen kartlar aracılığı ile iki tedavi grubuna [Grup 1: Geleneksel irrigasyon (pembe kart)], Grup 2: Vibringe (mavi kart) ayrılmıştır. Endodontik tedaviler tek seansta, tek bir klinisyen tarafından yapılmıştır. Tedaviden sonra, 6., 12., 24. ve 72. saatteki ağrıyı ve alınan analjeziği değerlendirmek için bütün katılımcılara sözel tarif skalası verilmiştir.
Bulgular: Gruplar arasında ağrılı diş sayısı bakımından 6., 24. ve 72. saatlerde anlamlı fark bulunmaz iken; 12. saat değerlendirmesinde ağrılı diş sayısı grup 2’de istatistiksel olarak daha fazla olmuştur. Bununla birlikte; tüm zaman dilimlerinde ağrı şiddeti, grup 1’de, grup 2’ye göre anlamlı derecede daha düşük çıkmıştır.
Sonuç: Bu çalışmanın sonucu; asemptomatik dişlerde Vibringe’ın kullanımının geleneksel enjektör ile kıyaslandığında postoperatif ağrıda artışa neden olabileceğini göstermektedir.

Keywords

Kök kanal tedavisi, dezenfeksiyon, postoperatif ağrı

Project Number

DHF2013LTP1

References

• 1. Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review. Int Endod J. 2008; 41(2): 91–99. doi: 10.1111/j.1365-2591.2007.01316.x.
• 2. Kaplan T, Kaplan SS, Sezgin GP. The effect of different irrigation and disinfection methods on post-operative pain in mandibular molars: a randomised clinical trial. BMC Oral Health. 2022; 22(1): 601. doi: 10.1186/s12903-022-02651-y.
• 3. Harrison JW, Baumgartner JC, Svec TA. Incidence of pain associated with clinical factors during and after root canal therapy. part 1. Interappointment pain. J Endod. 1983; 9(9): 384-387. doi: 10.1016/s0099-2399(83)80190-3.
• 4. Seltzer S, Naidorf IJ. Flare-ups in endodontics: 1. etiological factors. J Endod. 1985; 11(11): 472–478. doi: 10.1016/S0099-2399(85)80220-X.
• 5. Gondim Jr E, Setzer FC, Dos Carmo CB, et al. Postoperative pain after the application of two different irrigation devices in a prospective randomized clinical trial. J Endod. 2010; 36(8): 1295-1301. doi: 10.1016/j.joen.2010.04.012.
• 6. Sabeti MA, Nekofar M, Motahhary P, et al. Healing of apical periodontitis after endodontic treatment with and without obturation in dogs. J Endod. 2006; 32(7): 628-633. doi: 10.1016/j.joen.2005.12.014.
• 7. De-Deus G, Garcia-Filho P. Influence of the NiTi rotary system on the debridement quality of the root canal space. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108 (4): e71-76. doi: 10.1016/j.tripleo.2009.05.012.
• 8. Swanljung O, Vehkalahti MM. Root canal irrigants and medicaments in endodontic malpractice cases: a nationwide longitudinal observation. J Endod. 2018; 44(4): 559-564. doi: 10.1016/j.joen.2018.01.003.
• 9. Guivarc'h M, Ordioni U, Ahmed HMA, et al. Sodium hypochlorite accident: a systematic review. J Endod. 2017; 43(1): 16-24. doi: 10.1016/j.joen.2016.09.023.
• 10. Tanalp J, Gungor T. Apical Extrusion of Debris: A literature review of an inherent occurrence during root canal treatment. Int Endod J. 2014; 47(3): 211-221. doi: 10.1111/iej.12137.
• 11. Haapasalo M, Shen Y, Wang Z, et al. Irrigation in endodontics. Br Dent J. 2014; 216(6): 299-303. doi: 10.1038/sj.bdj.2014.204.
• 12. Alkahtani A, Al Khudhairi TD, Anil S. A comparative study of the debridement efficacy and apical extrusion of dynamic and passive root canal irrigation systems. BMC Oral Health. 2014; 14: 12. doi: 10.1186/1472-6831-14-12.
• 13. Caron G, Nham K, Bronnec F, et al. Effectiveness of different final irrigant activation protocols on smear layer removal in curved canals. J Endod. 2010; 36(8): 1361-1366. doi: 10.1016/j.joen.2010.03.037.
• 14. Dönmez Özkan H, Metin K, Bakir ZB, et al. A novel protein testing model to assay the efficacy of multiple irrigation activation techniques for removal of ex vivo biomolecular film. Photomed Laser Surg. 2018; 36(9): 493-498. doi: 10.1089/pho.2018.4452.
• 15. Rödig T, Bozkurt M, Konietschke F, et al. Comparison of the vibringe system with syringe and passive ultrasonic irrigation in removing debris from simulated root canal irregularities. J Endod. 2010; 36: 1410-1413. doi: 10.1016/j.joen.2010.04.023.
• 16. Blank-Gonçalves LM, Nabeshima CK, Martins GHR, et al. Qualitative analysis of the removal of the smear layer in the apical third of curved roots: conventional irrigation versus activation systems. J Endod. 2011; 37(9): 1268-1271. doi: 10.1016/j.joen.2011.06.009.
• 17. Johnson M, Sidow SJ, Looney SW, et al. Canal and isthmus debridement efficacy using a sonic irrigation technique in a closed-canal system. J Endod. 2012; 38(9): 1265-1268. doi: 10.1016/j.joen.2012.05.009.
• 18. Aksel H, Küçükkaya Eren S, Puralı N, et al. Efficacy of different irrigant protocols and application systems on sealer penetration using a stepwise CLSM analysis. Microsc Res Tech. 2017; 80(12): 1323-1327. doi: 10.1002/jemt.22944.
• 19. Karatas E, Ozsu D, Arslan H, et al. Comparison of the effect of nonactivated self‐adjusting file system, Vibringe, Endovac, ultrasonic and needle irrigation on apical extrusion of debris. Int Endod J. 2015; 48(4): 317-322. doi: 10.1111/iej.12317.
• 20. Ahmed S, Elfar H, El Khodary S. Evaluation of postoperative pain after using sonic Vibringe irrigation system versus conventional syringe irrigation in single rooted teeth with symptomatic irreversible pulpitis: a randomized clinical controlled trial. Advanced Dental Journal. 2019; 1(3): 86-94. doi: 10.21608/ADJC.2019.17020.1031
• 21. Ali MEM, Magdy A, Hussien W. Evaluation of post-operative pain after irrigation using end-vented NaviTip tips versus Vibringe sonic irrigating system in teeth with acute pulpitis with apical periodontitis: a randomized clinical trial. Open Access Maced J Med Sci. 2020; 8:130-133.
• 22. Arias, A, de la Macorra JC, Hidalgo JJ, et al. Predictive models of pain following root canal treatment: a prospective clinical study. Int Endod J. 2013; 46(8): 784-793. doi: 10.1111/iej.12059. Epub 2013 Feb 12.
• 23. Attar S, Bowles WR, Baisden MK, et al. Evaluation of pretreatment analgesia and endodontic treatment for postoperative endodontic pain. J Endod. 2008; 34(6): 652-655. doi: 10.1016/j.joen.2008.02.017.
• 24. Gündoğar M, Sezgin GP, Kaplan SS, et al. Postoperative pain after different irrigation activation techniques: a randomized, clinical trial. Odontology. 2021; 109: 385-392. doi: 10.1007/s10266-020-00553-5.
• 25. Dagher J, El Feghali R, Parker S, et al. Postoperative quality of life following conventional endodontic intracanal irrigation compared with laser-activated irrigation: a randomized clinical study. Photobiomodul Photomed Laser Surg. 2019; 37(4): 248-253. doi: 10.1089/photob.2018.4558.
• 26. Erkan E, Gündoğar M, Uslu G, et al. Postoperative pain after SWEEPS, PIPS, sonic and ultrasonic‑assisted irrigation activation techniques: a randomized clinical trial. Odontology. 2022; 110(4): 786-794. doi: 10.1007/s10266-022-00700-0.
• 27. Susila A, Minu J. Activated irrigation vs. conventional non-activated irrigation in endodontics–a systematic review. Eur Endod J. 2019; 4: 96-110. doi: 10.14744/eej.2019.80774.
• 28. Desai P, Himel V. Comparative safety of various intracanal irrigation systems. J Endod. 2009; 35: 545-549. doi: 10.1016/j.joen.2009.01.011.
• 29. Decurcio DA, Rossi-Fedele G, Estrela C, et al. Machine-assisted agitation reduces postoperative pain during root canal treatment: a systematic review and meta-analysis from randomized clinical trials. J Endod. 2019; 45(4): 387-393. doi: 10.1016/j.joen.2019.01.013.
• 30. Ramamoorthi S, Nivedhitha MS, Divyanand MJ. Comparative evaluation of postoperative pain after using endodontic needle and Endoactivator during root canal irrigation: a randomised controlled trial. Aust Endod J. 2015; 41(2): 78-87. doi: 10.1111/aej.12076.
• 31. Genet JM, Hart AAM, Wesselink PR, et al. Preoperative and operative factors associated with pain after the first endodontic visit. Int Endod J. 1987; 20(2): 53-64. doi: 10.1111/j.1365-2591.1987.tb00590.x.
• 32. Bamini L, Sherwood A, Arias A, et al. Influence of tooth factors and procedural errors on the incidence and severity of post-endodontic pain: a prospective clinical study. Dent J. 2020; 8(3): 73. doi: 10.3390/dj8030073.
• 33. Ince B, Ercan E, Dalli M, et al. Incidence of postoperative pain after single-and multi-visit endodontic treatment in teeth with vital and non-vital pulp. Eur J Dent. 2009; 3(4): 273–379.
• 34. Ng YL, Glennon, JP, Setchell DJ, et al. Prevalence of and factors affecting post‐obturation pain in patients undergoing root canal treatment. Int Endod J. 2004; 37(6): 381-391. doi: 10.1111/j.1365-2591.2004.00820.x.
• 35. Albashaireh ZSM, Alnegrish, AS. Postobturation pain after single-and multiple-visit endodontic therapy. a prospective study. J Dent. 1998; 26(3): 227-232. doi: 10.1016/s0300-5712(97)00006-7.
• 36. O'Keefe, E. M. Pain in endodontic therapy: preliminary study. J Endod. 1976; 2(10): 315-319. doi: 10.1016/S0099-2399(76)80047-7.
• 37. Guerreiro-Tanomaru, JM, Loiola LE, Morgental R, et al. Efficacy of four irrigation needles in cleaning the apical third of root canals. Braz Dent J. 2013; 24(1): 21-24. doi: 10.1590/0103-6440201302153.
• 38. Snjaric D, Carija Z, Braut A, et al. Irrigation of human prepared root canal--ex vivo based computational fluid dynamics analysis. Croat Med J. 2012; 53(5): 470-479. doi: 10.3325/cmj.2012.53.470.
• 39. Dorner TE, Muckenhuber J, Stronegger WJ, et al. The impact of socio-economic status on pain and the perception of disability due to pain. Eur J Pain. 2011; 15(1): 103–119. doi: 10.1016/j.ejpain.2010.05.013.
• 40. Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977; 196(4286): 129–136. doi: 10.1126/science.847460.