Comparison of Postoperative Pain after using Passive Ultra Sonic Activation (PUA) and Manual Dynamic Agitation (MDA) during Root Canal Treatment

Ahmed  Abdullah; Syed Muzammil Hussain; Shehroze  Azeem; Talha  Khurshid; Syed Shan e Haider  Naqvi

doi:10.51253/pafmj.v76iSUPPL-1.11887

Authors

Ahmed Abdullah Department of Operative Dentistry and Endodontics, Armed Forces Institute of Dentistry/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Syed Muzammil Hussain Department of Operative Dentistry and Endodontics, Armed Forces Institute of Dentistry/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Shehroze Azeem Department of Operative Dentistry and Endodontics, Armed Forces Institute of Dentistry/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Talha Khurshid Department of Operative Dentistry and Endodontics, Armed Forces Institute of Dentistry/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Syed Shan e Haider Naqvi Department of Operative Dentistry and Endodontics, Armed Forces Institute of Dentistry/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-1.11887

Keywords:

Manual Dynamic Agitation, Post-Operative Pain, Root Canal Treatment, Ultrasonic Activation

Abstract

Objective: To evaluate post-treatment pain after using manual dynamic agitation and passive ultrasonic activation as final irrigation activation protocols in endodontic therapies.

Study Design: Randomized Controlled Trial (clinicialtrials.gov: NCT05852444).

Place and Duration of Study: Department of Operative Dentistry and Endodontics, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from May to Nov 2023.

Methodology: In total, 90 patients were randomly split into 2 Groups. In Group MDA, master GP cones were used for irrigant agitation while in Group PUA, an ultrasonic device (Ultra-X) was used. Pain at three different intervals (8h, 24h, and 48h) was evaluated using VAS and NSAIDs were prescribed for pain relief.

Results: Pain scores differed substantially between the two Groups at 8, 24, and 48 hour time intervals (p<0.05). The Group PUA consistently showed a lower mean score at all three time intervals with the statistical analysis revealing significant differences in pain experience between Group PUA and Group MDA with a highly significant difference in pain distribution across all times.

Conclusion: Manual irrigant agitation with gutta percha cones causes significantly more pain than passive ultrasonic activation.

Downloads

Download data is not yet available.

References

postoperative pain after single-visit and multiple-visit root canal therapy: A randomized controlled trial. J Conserv Dent 2021; 24(4): 348-353. http://doi.org/10.4103/jcd.jcd_216_21

2. Vishwanathaiah S, Maganur PC, Khanagar SB, Chohan H, Testarelli L, Mazzoni A, et al. The incidence and intensity of postendodontic pain and flareup in single and multiple visit root canal treatments: A systematic review and meta-analysis. Appl Sci 2021; 11(8): 3358. http://doi.org/10.3390/app11083358

3. Gulabivala K, Ng YL. Factors that affect the outcomes of root canal treatment and retreatment—A reframing of the principles. Int Endodont J 2023; 56: 82-115.

http://doi.org/10.1111/iej.13897

4. Karkehabadi H, Yousefifakhr H, Zadsirjan S. Cytotoxicity of endodontic irrigants on human periodontal ligament cells. Iran Endodont J 2018; 13(3): 390.

https://doi.org/10.22037/iej.v13i3.20438

5. Versiani MA, Martins JN, Ordinola‐Zapata R. Anatomical complexities affecting root canal preparation: a narrative review. Aust Dent J 2023; 68(1): S5-23.

https://doi.org/10.1111/adj.12992

6. Siqueira Jr JF, Antunes HS, Pérez AR, Alves FR, Mdala I, Silva EJ, et al. The apical root canal system of teeth with posttreatment apical periodontitis: correlating microbiologic, tomographic, and histopathologic findings. J Endodont 2020; 46(9): 1195-1203. https://doi.org/10.1016/j.joen.2020.05.020

7. Krongbaramee T, Poochitpakorn S, Dewi A, Louwakul P, Srisuwan T. Synergistic effect of manual dynamic agitation and ethylenediaminetetraacetic acid containing 0.25% cetrimide on smear layer removal: An: in vitro: study. Saud Endodont J 2020; 10(3): 265-270.

http://doi.org/10.4103/sej.sej_161_19

8. ElAbbasy FE. Effect of Eighteeth Ultra X Ultrasonic activator device versus Syringe irrigation technique on reduction of Enterococcus Faecalis count inside the root canal space (An in-vitro study). Ain Shams Dent J 2022; 25(1): 56-62.

http://doi.org/10.21608/asdj.2022.162246.1141

9. Susila A, Minu J. Activated irrigation vs. conventional non-activated irrigation in endodontics–A systematic review. Eur Endodont J 2019; 4(3): 96.

https://doi.org/10.14744/eej.2019.80774

10. Western JS, Dicksit DD. Apical extrusion of debris in four different endodontic instrumentation systems: A meta-analysis. J conserv dent 2017; 20(1): 30.

https://doi.org/10.4103/0972-0707.209066

11. 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 Endodont J 2015; 41(2): 78-87.

https://doi.org/10.1111/aej.12076

12. Chalub LO, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Dos Santos PH, Gomes-Filho JE, et al. Postoperative pain in root canal treatment with ultrasonic versus conventional irrigation: a systematic review and meta-analysis of randomized controlled trials. Clin Oral Invest 2022; 26(4): 3343-3356.

https://doi.org/10.1007/s00784-022-04386-0

13. Izadpanah A, Javaheripour A, Maleki A, Alipour M, Hosseinifard H, Sharifi S, et al. The comparison of short-term postoperative pain in single-versus multiple-visit root canal treatment: A systematic review and meta-analysis study. Pain Res Manag 2021; 2021(1): 59898.

https://doi.org/10.4317%2Fjced.59898

14. Annapurani R, Shakunthala P, Sharmila S, Dhanalakshmi S, Nandhakumar J, Kaladevi M. Management of symptomatic irreversible pulpitis using irrigation agitation techniques in anterior teeth. Bioinformation 2023; 19(12): 1129.

https://doi.org/10.6026%2F973206300191129

15. Barbosa AF, Lima CO, Sassone LM, Fares RD, Fidalgo TK, Silva EJ. Effect of passive ultrasonic irrigation on hard tissue debris removal: a systematic review and meta-analysis. Brazil Oral Res 2021; 35(1): e123.

https://doi.org/10.1590/1807-3107bor-2021.vol35.0123

16. Sayed MM, Fahmy SH, Obeid MF. Post operative pain assessment after manual dynamic agitation at three different time intervals (An In vivo-study). Ain Shams Dent J 2021; 23(3): 1-6. http://doi.org/10.21608/asdj.2021.102981.1078

17. Topçuoğlu HS, Topçuoğlu G, Arslan H. The effect of different irrigation agitation techniques on postoperative pain in mandibular molar teeth with symptomatic irreversible pulpitis: a randomized clinical trial. J Endodont 2018; 44(10): 1451-1456.

https://doi.org/10.1016/j.joen.2018.06.008

18. Elzainy P, Hussein W, Hashem A, Badr M. Post-operative Pain after Different Root Canal Irrigant Activation Methods in Patients with Acute Apical Periodontitis (Randomized Clinical Trial). Open Access Maced J Med Sci 2022; 10(D): 331-337.

https://doi.org/10.3889/oamjms.2022.10156