Comparative Evaluation of Postoperative Pain After Root Canal Preparation with Rotary (Hyflex EDM) vs Reciprocating (Reciproc VDW) System in Molar Teeth: A Randomized Controlled Trial
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-10.13265Keywords:
Hyflex EDM, Numerical Rating Score, Postoperative Pain, Reciproc, Root Canal TreatmentAbstract
Objective: To evaluate and compare postoperative pain experienced by patients undergoing root canal treatment using continuous rotation (Hyflex EDM) vs reciprocating (Reciproc) instrumentation systems.
Study Design: Randomized controlled trial (NCT06779565).
Place and Duration of Study: 21 Military Dental Centre, Quetta, Pakistan, from Aug 2024 to Jan 2025.
Methodology: Patients were randomly divided into two groups to receive root canal therapy using either the Reciproc or Hyflex EDM instrument systems. The therapy was carried out over two sessions, and postoperative pain was measured using the Numerical Rating Scale (NRS) at intervals of 6-, 12-, 18-, 24-, 48-, and 72-hours after treatment. Post-operative swelling was recorded using a modified Gabka and Matsumura Scale.
Results: Group-A (Hyflex EDM) and Group-B (Reciproc) had the same distribution of gender, pulp vitality, and tooth type. The mean numerical rating scale score was significantly higher in Group-B compared to Group-A at all-time points (p < 0.05). Except for 48 hours during the first visit, Group B's mean swelling was significantly higher than Group-A's at 6-, 12-, 18-, and 24-hour periods. On the contrary, a significant difference was observed at the second visit after 6 hours (p = 0.041).
Conclusion:
The Hyflex EDM system significantly reduces postoperative pain after endodontic therapy compared to the Reciproc system
Downloads
References
1. Sharma A, Nirupama DN, Nainan MT, Vijay R, Thomas H, Yasin S. Quantitative evaluation of the apically extruded debris from root canals prepared by single-file rotary and reciprocating file systems: An in vitro study. J Conserv Dent Endod 2024; 27(8): 860-865. http://doi.org/10.4103/JCDE.JCDE_275_24
2. Gençoğlu N, Karatekin AÖ, Gündoğar M. Postoperative pain following single-visit root canal treatment with Reciproc Blue and HyFlex EDM instrumentation: a prospective randomized clinical trial. Meandros Med Dent J 2024; 25(1): 78-84.
http://doi.org/10.69601/meandrosmdj.1508747
3. Al Omari TMN, La Rosa GRM, Albanna RHI, Tabnjh A, Papale F, Pedullà E. The effect of different kinematics on apical debris extrusion with a single-file system. Odontology 2023; 111(4): 910-915. http://doi.org/10.1007/s10266-023-00802-3
4. Puleio F, Giordano F, Bellezza U, Rizzo D, Coppini V, Lo Giudice R. Do Continuous Rotating Endodontic Instruments Extrude Fewer Apical Debris Than Reciprocating Instruments in Non-Surgical Endodontic Retreatments? A Systematic Review. Appl Sci 2024; 14(4): 1621.
http://doi.org/10.3390/app14041621
5. Chaudhary GK, Alam MS, Hossain M. Clinical efficacy and safety between continuous rotary and reciprocating root canal instrumentation systems. J Chitwan Med Coll 2021; 11(3): 119-125. http://doi.org/10.3126/jcmc.v11i3.40144
6. Shahnawaz S, Shahroz N, Zafar MA, Sajjad S, Pasha M, Hussain AS. Comparison of two different file systems on postoperative pain after root canal instrumentation: A randomized controlled trial. Acta Marisiensis Ser Med 2023; 69(1): 37–44.
http://doi.org/10.2478/amma-2023-0006
7. Kumar U, Parmar P, Vashisht R, Tandon N, Kaur CK. Incidence of postoperative pain after using single continuous, single reciprocating, and full sequence continuous rotary file system: a prospective randomized clinical trial. J Dent Anesth Pain Med 2023; 23(2): 91-99. http://doi.org/10.17245/jdapm.2023.23.2.91
8. Saberi AE, Ebrahimipour S, Saberi M. Apical Debris Extrusion with Conventional Rotary and Reciprocating Instruments. Iran Endod J 2020; 15(1): 38-43.
http://doi.org/10.22037/iej.v15i1.23823
9. Oliveira PS, Ferreira MC, Paula NGN, Loguercio AD, Grazziotin-Soares R, da Silva GR, et al. Postoperative Pain Following Root Canal Instrumentation Using ProTaper Next or Reciproc in Asymptomatic Molars: A Randomized Controlled Single-Blind Clinical Trial. J Clin Med 2022; 11(13): 3816.
http://doi.org/10.3390/jcm11133816
10. Ahmad MZ, Sadaf D, MacBain MM, Mohamed AN. Apical extrusion of debris with different rotary and reciprocating single-file endodontic instrumentation systems: a systematic review and meta-analysis protocol. BMJ Open 2020; 10(9): e038502. http://doi.org/10.1136/bmjopen-2020-038502
11. Lima Neto JC, Fernandes LM, Magno MB, Rocha Lima TF, de Almeida LFD, Santiago BM, et al. The effect of reciprocating and rotary systems on postoperative endodontic pain: a systematic review and meta-analysis. Iran Endod J 2020; 15(4): 198–210.
http://doi.org/10.22037/iej.v15i4.23778
12. da Silveira MT, Batista SM, Mamede Veloso SR, de Oliveira NG, de Vasconcelos Carvalho M, et al. Effect of reciprocating and rotary systems on postoperative pain: a systematic review and meta-analysis. Iran Endod J 2021; 16(1): 1–16.
http://doi.org/10.22037/iej.v16i1.27944
13. Çanakçi BC, Er Ö, Genç Şen Ö, Süt N. The effect of two rotary and two reciprocating NiTi systems on postoperative pain after root canal retreatment on single‐rooted incisor teeth: a randomized controlled trial. Int Endod J 2021.
http://doi.org/10.1111/iej.13609
14. Ikhar A, Jaiswal A, Chandak M, Chaudhari P. Comparative evaluation of postoperative pain after single-visit endodontic treatment using Protaper Gold and Hyflex electrical discharge machining rotary file system. J Datta Meghe Inst Med Sci Univ 2023; 18(1): 58–62.
http://doi.org/10.4103/jdmimsu.jdmimsu_541_22
15. Uzunoğlu Özyürek E, Küçükkaya Eren S, Karahan S. Effect of treatment variables on apical extrusion of debris during root canal retreatment: a systematic review and meta-analysis of laboratory studies. J Dent Res Dent Clin Dent Prospects 2024; 18(1): 1–16. http://doi.org/10.34172/joddd.40501
16. Kharouf N, Pedullà E, Nehme W, Akarma K, Mercey A, Gros CI, et al. Apically extruded debris in curved root canals using a new reciprocating single-file shaping system. J Endod 2022; 48(1): 117–122. http://doi.org/10.1016/j.joen.2021.10.002
17. Ahmad MZ, Sadaf D, MacBain MM, Merdad KA. Effect of mode of rotation on apical extrusion of debris with four different single‐file endodontic instrumentation systems: systematic review and meta‐analysis. Aust Endod J 2022 ; 48(1): 202-218.
http://doi.org/10.1111/aej.12612
18. Sepah NG, Qureshi A, Khattak MI, Ali MI, Iqbal A, Iqbal M. Comparison of the mean postoperative pain after manual and rotary instrumentation for root canal treatment of single-rooted teeth with irreversible pulpitis. J Ayub Med Coll Abbottabad 2024; 36(4 Suppl 1).
http://doi.org/10.55519/jamc-s4-12506
19. Abdelnaby P, Ibrahim M, ElBackly R. In vitro evaluation of filling material removal and apical debris extrusion after retreatment using Reciproc Blue, Hyflex EDM and ProTaper retreatment files. BMC Oral Health 2023; 23(1).
http://doi.org/10.1186/s12903-023-03579-7
20. Iqbal W, Rehman A, Zehra SZ, Zehra B, Nazneen, Ather M, et al. A correlation between post-operative pain in single visit rotary versus hand K-files root canal treatment: a randomized clinical trial. EC Dent Sci 2020; 19(3): 1–6.
21. Rana MA, Shah SAR, Iqbal A, Haroon S, Khan M, Gilani SBS. Quality of root canal filling in manually and rotary-filed single-rooted teeth. Pak J Med Health Sci 2022; 16(12): 551–553.
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 Ahmed Abdullah, Shehroze Azeem, Atta Ur Rehman, Sumaira Zaman, Zainab ur Rehman Shah, Nigarish Javaid
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
