Research Article

Postoperative pain and quality of life after sonic irrigation with Waterpik dental flosser home care device: a randomized clinical trial

Volume: 60 Number: 1 June 17, 2026
EN

Postoperative pain and quality of life after sonic irrigation with Waterpik dental flosser home care device: a randomized clinical trial

Abstract

Purpose

This study aimed to evaluate the effect of irrigation agitation on postoperative pain (PP) and oral health-related quality of life (OHQoL) in patients undergoing singlevisit root canal therapy (RCT).

Materials and methods

The study was a double-blind randomized clinical trial where a single-visit RCT was performed on forty patients diagnosed with symptomatic irreversible pulpitis in molars. The study participants were divided into two groups (n=20) based on the final irrigation protocol. Group 1- No agitation (NA), Group 2: Sonic agitation (SA). The pain scores were recorded using the Visual Analogue Rating scale (VAS) preoperatively and postoperative at 6, 12, 24, 48 and 72 hours. The OHQoL scores were recorded before and 72 hours after the treatment using the oral health impact profile (OHIP-14). Statistical analysis was performed for inter- and intra-group comparisons using Mann-Whitney U test and the Wilcoxon Signed Rank Test.

Results

Lower pain scores were observed in the sonic agitation group at 12 hours (p=0.03),24 hours(p=0.02),48 hours (p=0.02),72 hours (p=0.04) after RCT. The patient’s OHQoL

was improved postoperatively (p=0.278), but there was no significant difference between sonic agitation and the control groups.

Conclusion

Endodontic treatment improved patients’ quality of life, and sonic irrigation agitation using a Waterpik device reduced postoperative pain in patients with symptomatic irreversible pulpitis.

Keywords

Supporting Institution

Narayana dental college and hospital

Ethical Statement

The clinical trial study was approved by institutional ethics committee under the proposal number- IEC/NDCH/2023/NOV/P-101 and registered in clinical trial registry of India- CTRI/2024/01/062145

References

  1. Milojevic N, Krdzovic Lazic E, Lukic L, Puresevic D, Mirkovic M, Jakovljevic A. Inflammatory mediators’ essence in apical periodontitis. Eur Oral Res. 2024;58:160–8. [CrossRef ] google scholar
  2. American Association of Endodontists (AAE). Glossary of endodontic terms. 10th ed. Chicago:AAE;2021. google scholar
  3. Zanjir M, Cardoso E, Harman NL, Khansari A, Jafarzadeh H, Malkhassian G, et al. Development of a Core Outcome Set in Endodontics (COS-ENDO):Part 5 - COS-ENDO for studies of apexification and regenerative endodontics in permanent teeth. J Endod. 2025;51:457–72. [CrossRef ] google scholar
  4. Gomes BP, Aveiro E, Kishen A. Irrigants and irrigation activation systems in Endodontics. Braz Dent J. 2023;34:1–33. [CrossRef ] google scholar
  5. Decurcio DA, Rossi-Fedele G, Estrela C, Pulikkotil SJ, Nagendrababu V. Machine-assisted Agitation Reduces Postoperative Pain during Root Canal Treatment:A Systematic Review and Meta-analysis from Randomized Clinical Trials. J Endod. 2019;45:387–393. e2. [CrossRef ] google scholar
  6. Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod. 2009;35:791–804. [CrossRef ] google scholar
  7. Govula K, Prasad G, Kumar YP, Kowmudi M, Swapna S, Mungara N. Efficacy of EndoActivator on the Postoperative Pain in the Teeth with Symptomatic Irreversible Pulpitis:A Systematic Review and Meta-Analysis. J Int Oral Health. 2023;15:319–27. [CrossRef ] google scholar
  8. Hemalatha S, Srinivasan A, Srirekha A, Santhosh L, Champa C, Shetty A. An in vitro radiological evaluation of irrigant penetration in the root canals using three different irrigation systems:waterpik WP-100 device, passive irrigation, and manual dynamic irrigation systems. J Conserv Dent. 2022;25:403–8. [CrossRef ] google scholar

Details

Primary Language

English

Subjects

Endodontics

Journal Section

Research Article

Publication Date

June 17, 2026

Submission Date

May 31, 2025

Acceptance Date

October 20, 2025

Published in Issue

Year 2026 Volume: 60 Number: 1

APA
Laddagiri, N. K., Sannapureddy, S., Govula, K., A, L., Maddineni, K., & Chinni, S. K. (2026). Postoperative pain and quality of life after sonic irrigation with Waterpik dental flosser home care device: a randomized clinical trial. European Oral Research, 60(1), 130-136. https://doi.org/10.26650/eor.20251709594
AMA
1.Laddagiri NK, Sannapureddy S, Govula K, A L, Maddineni K, Chinni SK. Postoperative pain and quality of life after sonic irrigation with Waterpik dental flosser home care device: a randomized clinical trial. EOR. 2026;60(1):130-136. doi:10.26650/eor.20251709594
Chicago
Laddagiri, Nagamuni Keerthana, Swapna Sannapureddy, Kıranmayı Govula, Lavanya A, Kowmudi Maddineni, and Suneel Kumar Chinni. 2026. “Postoperative Pain and Quality of Life After Sonic Irrigation With Waterpik Dental Flosser Home Care Device: A Randomized Clinical Trial”. European Oral Research 60 (1): 130-36. https://doi.org/10.26650/eor.20251709594.
EndNote
Laddagiri NK, Sannapureddy S, Govula K, A L, Maddineni K, Chinni SK (June 1, 2026) Postoperative pain and quality of life after sonic irrigation with Waterpik dental flosser home care device: a randomized clinical trial. European Oral Research 60 1 130–136.
IEEE
[1]N. K. Laddagiri, S. Sannapureddy, K. Govula, L. A, K. Maddineni, and S. K. Chinni, “Postoperative pain and quality of life after sonic irrigation with Waterpik dental flosser home care device: a randomized clinical trial”, EOR, vol. 60, no. 1, pp. 130–136, June 2026, doi: 10.26650/eor.20251709594.
ISNAD
Laddagiri, Nagamuni Keerthana - Sannapureddy, Swapna - Govula, Kıranmayı - A, Lavanya - Maddineni, Kowmudi - Chinni, Suneel Kumar. “Postoperative Pain and Quality of Life After Sonic Irrigation With Waterpik Dental Flosser Home Care Device: A Randomized Clinical Trial”. European Oral Research 60/1 (June 1, 2026): 130-136. https://doi.org/10.26650/eor.20251709594.
JAMA
1.Laddagiri NK, Sannapureddy S, Govula K, A L, Maddineni K, Chinni SK. Postoperative pain and quality of life after sonic irrigation with Waterpik dental flosser home care device: a randomized clinical trial. EOR. 2026;60:130–136.
MLA
Laddagiri, Nagamuni Keerthana, et al. “Postoperative Pain and Quality of Life After Sonic Irrigation With Waterpik Dental Flosser Home Care Device: A Randomized Clinical Trial”. European Oral Research, vol. 60, no. 1, June 2026, pp. 130-6, doi:10.26650/eor.20251709594.
Vancouver
1.Nagamuni Keerthana Laddagiri, Swapna Sannapureddy, Kıranmayı Govula, Lavanya A, Kowmudi Maddineni, Suneel Kumar Chinni. Postoperative pain and quality of life after sonic irrigation with Waterpik dental flosser home care device: a randomized clinical trial. EOR. 2026 Jun. 1;60(1):130-6. doi:10.26650/eor.20251709594