Assessment of the relationship between different irrigation activation techniques and postoperative pain and tenderness to percussion

INTERVENTION: Vital pulp mandibular premolar teeth (single canal) were selected from either asymptomatic irreversible pulpitis such as deep dentine caries and secondary caries, or normal pulps that were referred for prosthetic reasons. 20 mandibular premolars were randomised to one of five groups: conventional irrigation (CI), manual dynamic irrigation (MDI), passive ultrasonic irrigation (PUI), EndoVac irrigation (EV) and photon‐initiated photoacoustic streaming irrigation (PIPSI) techniques were applied as the means of final irrigation of the root canals. The final irrigation was performed with the five different techniques after the canals were enlarged. The endodontic treatment of the teeth was completed in a single session. The spontaneous pain and tenderness to percussion analyses were performed after 6, 24 and 48 hours. A visual analogue scale (VAS) was used to measure spontaneous pain and tenderness to percussion. The statistical analyses were performed using the Kruskal‐Wallis and Mann‐Whitney U tests. The irrigation protocols are detailed in terms of both quantity and time. Concentrations of 17% EDTA and 2.5% NaOCl were used in all the groups. Conventional irrigation (CI) An irrigation cannula was adjusted 1 mm coronal to the working length. During the irrigation, the cannula was moved 2 mm up and down in this area. As intracanal irrigation, both 2 ml/min EDTA and 5 ml/min NaOCl were used. In this group, 2 ml EDTA and 5 ml NaOCl were used. Manual dynamic irrigation (MDI) The location of the injector and the quantity/time of the irrigation were the same as in the CI group. During the activation, a gutta‐percha cone that was one size smaller than the master gutta‐percha cone (Micro Mega, Besancon, France) was selected. The cone was adjusted 1 mm coronal to the working length and it was activated at a rate of 100 push‐pull strokes per minute. In this group, 2 ml EDTA and 5 ml NaOCl were used. Passive ultrasonic irrigation (PUI) The location of the injector and the qu CONDITION: Root canal treatment (endodontics) ; Oral Health PRIMARY OUTCOME: Pain measured using a visual analogue scale (VAS) from 0 to 10 (0 = no pain, 10 = extremely strong, maximum pain) after 6, 24 and 48 hours SECONDARY OUTCOME: Percussion assessments performed using the handle of a mirror by the same clinician using the same force and the same posture after 6, 24 and 48 hours INCLUSION CRITERIA: 1. Age 18‐60 2. Male or female