Effect of Reciprocating versus Rotary Instrumentation on Post-endodontic Pain and Endotoxins Level in Infected Root Canals: A Randomised Clinical Trial
Keywords:endotoxins, post-endodontic pain, primary endodontic infection, ProTaper Next, WaveOne Gold.
Background: This randomised, prospective, controlled trial aimed to assess the effect of reciprocating
single-file and rotary instrumentation on the intensity of postoperative pain and the amount of endotoxins in
primarily infected root canals.
Methodology: Forty participants were randomly assigned into two equal groups according to root canal
instrumentation technique (n = 20), control group: root canals were instrumented using ProTaper Next rotary
system and intervention group: canals were instrumented using WaveOne Gold reciprocating instrumentation
system. Root canal treatment was carried out on two visits and postoperative pain of participants was
measured using a numerical rating scale (NRS) at predetermined time intervals 6, 12, 24, 48 hours after
instrumentation and obturation appointments. Quantification of endotoxins was done using the Sandwich-
ELISA method at predetermined time intervals (after access cavity preparation and after completion of
instrumentation). Pain score data were summarised as mean and standard deviation.
Results: No statistically significant difference was noted between the single-file reciprocating system
(WaveOne Gold) and the multiple-file rotary system (ProTaper Next) regarding postoperative pain and
reduction in the amount of endotoxins (P > 0.05).
Conclusion: Both single-file reciprocating instruments and multi-file rotary instruments resulted in mild to
moderate postoperative pain and comparable reduction of endotoxins level.
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