Effect of Rotary and Reciprocating File System on Postoperative Pain in Single Visit Endodontic treatment: A Randomised Clinical Trial

Introduction: In modern times, endodontic intervention is preferred and tooth extraction is becoming increasingly rare. Root Canal Therapy (RCT) is well-established, with success rates exceeding 90%. A key contributor to post-endodontic pain is the extrusion of debris into the periapical region, which causes inflammation and nerve compression. The amount of debris extruded varies with instrumentation techniques and no current technology completely prevents it. Rotary and reciprocating Nickel-Titanium (NiTi) instruments, each with distinct designs and kinematics, play a critical role in managing this complication. Aim: To evaluate postoperative pain using rotary and reciprocating file systems in single visit endodontics. Materials and Methods: This prospective, parallel-group, singlecentre, double-blinded, equivalence, randomised clinical study was conducted at the Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed To be University), Karad, Maharashtra, India, from October 2023 to March 2024, with the aim of comparing postoperative pain following endodontic therapy using two reciprocating systems, WaveOne Gold (WOG) and E-Flex Rec, versus two rotary systems, Mtwo and XP Endo Shaper (XPES). A total of 80 patients with symptomatic irreversible pulpitis were enrolled and randomly assigned to four groups, each treated with one of the four endodontic file systems. Patients were randomised into four groups: 1A-Mtwo (Dentsply-Maillefer, Ballaigues, Switzerland); 1B-XP Endo Shaper (XPS; FKG Dentaire SA, La Chaux-de-Fonds, Switzerland); 2A-Eighteeth E-Flex Rec File; and 2B-WOG (Dentsply Sirona, York, PA). Postoperative pain scores were measured using the Visual Analogue Scale (VAS) at 24, 48 and 72 hours and seven days post-treatment. Statistical analysis was conducted using One-way Analysis of Variance (ANOVA) with Tukey’s post-hoc test and Chi-square tests for categorical data using Statistical Package for Social Sciences (SPSS) software version 21.0, with p-values