Skip to main content

Advertisement

SpringerLink
Log in

Effect of solvent use on postoperative pain in root canal retreatment: a randomized, controlled clinical trial

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

The aim of this randomized clinical trial was to assess the effect of solvent use during the removal of root canal filling on postoperative pain after retreatment.

Materials and methods

Ninety patients scheduled for root canal retreatment were randomly assigned to one of the following two groups according to the root canal filling removal procedure used: ProTaper retreatment (Dentsply Maillefer, Ballaigues, Switzerland) instruments or ProTaper retreatment instruments in combination with gutta-percha solvent. A single operator performed the retreatments in a single visit. The incidence and intensity of the postoperative pain were rated on a numeric rating scale by patients at 24, 48, and 72 h after retreatment. The analgesic tablet intake number was also recorded. Data were analyzed using Mann‑Whitney U, Wilcoxon, and chi-square tests.

Results

For the intensity of postoperative pain, the difference between the two groups was not statistically significant. Moreover, no statistically significant difference was found between the two groups in terms of analgesic medication intake (P > 0.05).

Conclusions

The processes involving the use and non-use of a solvent in the removal of root canal fillings were found to be equivalent in terms of postoperative pain intensity and analgesic intake.

Clinical relevance

Some in vitro studies claimed that the use of a gutta-percha solvent in the removal of root canal fillings tends to reduce postoperative pain since extrusion of debris was significantly less. This randomized clinical trial indicates that the removal of root canal fillings with or without the use of a solvent was associated with equivalent postoperative pain intensity and analgesic intake.

This study is registered in the www.ClinicalTrials.gov database with the identifier number NCT03756363.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Siqueira JF Jr (2003) Microbial causes of endodontic flare-ups. Int Endod J 36:453–463

    Article  PubMed  Google Scholar 

  2. Seltzer S, Naidorf IJ (2004) Flare-ups in endodontics: I. etiological factors. J Endod 30:476–481

    Article  PubMed  Google Scholar 

  3. Pirani C, Pelliccioni GA, Marchionni S, Montebugnoli L, Piana G, Prati C (2009) Effectiveness of three different retreatment techniques in canals filled with compacted gutta-percha or Thermafil: a scanning electron microscope study. J Endod 35:1433–1440

    Article  PubMed  Google Scholar 

  4. Betti L, Bramante CM (2001) Quantec SC rotary instruments versus hand files for gutta-percha removal in root canal retreatment. Int Endod J 34:514–519

    Article  PubMed  Google Scholar 

  5. Bürklein S, Schäfer E (2012) Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems. J Endod 38:850–852

    Article  PubMed  Google Scholar 

  6. Yılmaz K, Özyürek T (2017) Apically extruded debris after retreatment procedure with Reciproc, ProTaper next, and twisted file adaptive instruments. J Endod 43:648–651

    Article  PubMed  Google Scholar 

  7. Silva EJ, Sá L, Belladonna FG, Neves AA, Accorsi-Mendonça T, Vieira VT, Moreira EJ (2014) Reciprocating versus rotary systems for root filling removal: assessment of the apically extruded material. J Endod 40:2077–2080

    Article  PubMed  Google Scholar 

  8. Caviedes-Bucheli J, Castellanos F, Vasquez N, Ulate E, Munoz HR (2016) The influence of two reciprocating single-file and two rotary-file systems on the apical extrusion of debris and its biological relationship with symptomatic apical periodontitis a systematic review and meta-analysis. Int Endod J 49:255–270

    Article  PubMed  Google Scholar 

  9. Gordon MP (2005) The removal of gutta-percha and root canal sealers from root canals. N Z Dent J 101:44–52

    PubMed  Google Scholar 

  10. Viducic D, Jukic S, Karlovic Z, Bozic Z, Miletic I, Anic I (2003) Removal of gutta-percha from root canals using an Nd:YAG laser. Int Endod J 36:670–673

    Article  PubMed  Google Scholar 

  11. Hülsmann M, Bluhm V (2004) Efficacy, cleaning ability and safety of different rotary NiTi instruments in root canal retreatment. Int Endod J 37:468–476

    Article  PubMed  Google Scholar 

  12. Kaplowitz GJ (1990) Evaluation of gutta-percha solvents. J Endod 16:539–540

    Article  PubMed  Google Scholar 

  13. Görduysus MO, Tasman E, Tuncer S, Etikan I (1997) Solubilizing efficiency of different gutta percha solvents: a comparative study. J Nihon Univ Sch Dent 39:133–135

    Article  PubMed  Google Scholar 

  14. Erdemir A, Eldeniz AU, Belli S (2004) Effect of the gutta-percha solvents on the microhardness and the roughness of human root dentine. J Oral Rehabil 31:1145–1148

    Article  PubMed  Google Scholar 

  15. Magalhães BS, Johann JE, Lund RG, Martos J, Del Pino FA (2007) Dissolving efficacy of some organic solvents on gutta-percha. Braz Oral Res 21:303–307

    Article  PubMed  Google Scholar 

  16. Pécora JD, Spanó JCE, Barbin EL (1993) In vitro study on the softening of gutta-percha cones in endodontic retreatment. Braz Dent J 4:43–47

    PubMed  Google Scholar 

  17. Giuliani V, Cocchetti R, Pagavino G (2008) Efficacy of ProTaper universal retreatment files in removing filling materials during root canal retreatment. J Endod 34:1381–1384

    Article  PubMed  Google Scholar 

  18. Gu LS, Ling JQ, Wei X, Huang XY (2008) Efficacy of ProTaper universal rotary retreatment system for gutta-percha removal from root canals. Int Endod J 41:288–295

    Article  PubMed  Google Scholar 

  19. Takahashi CM, Cunha RS, Martin AS, Fontana CE, Silveria CF, da Silveira Bueno CE (2009) In vitro evaluation of the effectiveness of ProTaper universal rotary retreatment system for gutta-percha removal with or without solvent. J Endod 35:1580–1583

    Article  PubMed  Google Scholar 

  20. Ruddle C (2001) The ProTaper endodontic system: geometries, features and guidelines for use. Dent Today 20:60–67

    PubMed  Google Scholar 

  21. Çanakçı BC, Er Ö, Dinçer A (2015) Do sealer solvents used effect apically extruded debris in retreatment. J Endod 41:1507–1509

    Article  PubMed  Google Scholar 

  22. Türker S, Uzunoğlu F, Sağlam BC (2015) Evaluation of the amount of extruded debris during retreatment of root canals filled by different obturation techniques. Niger J Clin Pract 18:802–806

    Article  PubMed  Google Scholar 

  23. Ørstavik D (1986) The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol 2:20–34

    Article  PubMed  Google Scholar 

  24. Ørstavik D (1996) Time-course and risk analyses of the development and healing of chronic apical periodontitis in man. Int Endod J 29:150–155

    Article  PubMed  Google Scholar 

  25. Rodriguez CS (2001) Pain measurement in the elderly: a review. Pain Manag Nurs 2:38–46

    Article  PubMed  Google Scholar 

  26. Johnson C (2005) Measuring pain. Visual analog scale versus numeric pain scale: what is the difference? J Chiropr Med 4:43–44

    Article  PubMed  PubMed Central  Google Scholar 

  27. Siqueira JF Jr, Rôças IN, Favieri A, Machado AG, Gahyva SM, Oliviera JCM et al (2002) Incidence of postoperative pain after intracanal procedures based on an antimicrobial strategy. J Endod 28:457–460

    Article  PubMed  Google Scholar 

  28. Gama TGV, Machado de Oliviera JC, Abad EC, Rôças IN, Siqueira JF Jr (2008) Postoperative pain following the use of two different intracanal medications. Clin Oral Investig 12:325–330

    Article  PubMed  Google Scholar 

  29. Tsesis I, Faivishevsky V, Fuss Z, Zukerman O (2008) Flare-ups after endodontic treatment: a meta-analysis of literature. J Endod 34:1177–1181

    Article  PubMed  Google Scholar 

  30. Gehlot PM, Manjunath V, Manjunath MK (2016) An in vitro evaluation of four electronic apex locators using stainless steel and nickel titanium hand files. Rest Dent Endod 41:6–11

    Article  Google Scholar 

  31. Al-Omari MA, Dummer PMH (1995) Canal blockage and debris extrusion with eight preparation techniques. J Endod 21:154–158

    Article  PubMed  Google Scholar 

  32. Haapasalo M, Udnæs T, Endal U (2003) Persistent,recurrent and acquired infection of the root canal system post-treatment. Endod Top 6:29–56

    Article  Google Scholar 

  33. Chutich MJ, Kaminski EJ, Miller DA, Lautenschlager EP (1998) Risk assessment of the toxicity of solvents of gutta-percha used in endodontic retreatment. J Endod 24:213–216

    Article  PubMed  Google Scholar 

  34. Graunaite I, Skucaite N, Ladiene G, Agentiene I, Machiulskiene V (2018) Effect of resin based and bioceramic root canal sealers on postoperative pain: a split-mouth randomized clinical trial. J Endod 44:689–693

    Article  PubMed  Google Scholar 

  35. Arora M, Sangwan P, Tewari S, Duhan J (2016) Effect of maintaining apical patency on endodontic pain in posterior teeth with pulp necrosis and apical periodontitis: a randomized controlled trial. Int Endod J 49:317–324

    Article  PubMed  Google Scholar 

  36. Pak JG, White SN (2011) Pain prevalence and severity before, during, and after root canal treatment: a systematic review. J Endod 37:429–438

    Article  PubMed  Google Scholar 

  37. Hawker GA, Mian S, Kendzerska T, French M (2011) Measures of adult pain. Arthritis Care Res 63:240–252

    Article  Google Scholar 

  38. Kusner G, Reader A, Beck FM, Weaver J, Meyers W (1984) A study comparing the effectiveness of ibuprofen (Motrin), Empirin with codeine #3, and Synalgos-DC for the relief of postendodontic pain. J Endod 10:210–214

    Article  PubMed  Google Scholar 

  39. Keiser K, Byrne BE (2011) Endodontic pharmacology. In: Hargreaves KM, Cohen S (eds) Pathways of the pulp, 10th edn. Mosby Elsevier, St Louis, pp 671–690

    Chapter  Google Scholar 

  40. Walton R, Fouad A (1992) Endodontic interappointment flare-ups: a prospective study of incidence and related factors. J Endod 18:172–177

    Article  PubMed  Google Scholar 

  41. Mattscheck DJ, Law AS, Noblett WC (2001) Retreatment versus initial root canal treatment: factors affecting posttreatment pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 92:321–324

    Article  PubMed  Google Scholar 

  42. Imura N, Zuolo ML (1995) Factors associated with endodontic flare- ups: a prospective study. Int Endod J 28:261–265

    Article  PubMed  Google Scholar 

  43. de Oliveira Alves V (2010) Endodontic flare-ups: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110:e68–e72

    Article  Google Scholar 

  44. Comparin D, Moreira EJL, Souza EM, De-Deus G, Arias A, Silva EJNL (2017) Postoperative pain after endodontic retreatment using rotary or reciprocating instruments: a randomized clinical trial. J Endod 43:1084–1088

    Article  PubMed  Google Scholar 

  45. Wise EA, Price DD, Myers CD, Heft MW, Robinson ME (2002) Gender role expectations of pain: relationship to experimental pain perception. Pain 96:335–342

    Article  PubMed  PubMed Central  Google Scholar 

  46. Ertan T, Şahinkesen G, Tunca YM (2010) Evaluation of postoperative pain in root canal treatment. Agri 22:159–164

    PubMed  Google Scholar 

  47. Arias A, de la Macorra JC, Hidalgo JJ, Azabal M (2013) Predictive models of pain following root canal treatment: a prospective clinical study. Int Endod J 46:784–793

    Article  PubMed  Google Scholar 

  48. Watkins CA, Logan HL, Kirchner HL (2002) Anticipated and experienced pain associated with endodontic therapy. J Am Dent Assoc 133:45–54

    Article  PubMed  Google Scholar 

  49. Ng YL, Glennon JP, Setchell DJ, Gulabivala K (2004) Prevalence of and factors affecting post-obturation pain in patients undergoing root canal treatment. Int Endod J 37:381–391

    Article  PubMed  Google Scholar 

  50. Garcia-Font M, Durán-Sindreu F, Morelló S, Irazusta S, Abella F, Roig M, Olivieri JG (2018) Postoperative pain after removal of gutta-percha from root canals in endodontic retreatment using rotary or reciprocating instruments: a prospective clinical study. Clin Oral Investig 22:2623–2631

    Article  PubMed  Google Scholar 

  51. Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ et al (2010) CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ 340:c869

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors gratefully acknowledge Prof. Dr. Sıddık Keskin for performing the statistical analysis.

Author information

Authors and Affiliations

  1. Department of Endodontics, Faculty of Dentistry, Van Yuzuncu Yil University Zeve Campus, Bardakci Mahallesi, 65080, Tuşpa, Van, Turkey

    Ozgur Genc Sen & Ali Erdemir

  2. Department of Endodontics, Faculty of Dentistry, Trakya University Balkan Campus, 2213 Iskender Koyu, Edirne, Turkey

    Burhan Can Canakci

Authors
  1. Ozgur Genc Sen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ali Erdemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Burhan Can Canakci
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ozgur Genc Sen.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from each of the participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Genc Sen, O., Erdemir, A. & Canakci, B.C. Effect of solvent use on postoperative pain in root canal retreatment: a randomized, controlled clinical trial. Clin Oral Invest 24, 257–263 (2020). https://doi.org/10.1007/s00784-019-02948-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-019-02948-3

Keywords

Search

Navigation