The Effect of Different Irrigation Agitation Techniques on Postoperative Pain in Mandibular Molar Teeth with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial

This study compared the effect of several final irrigation agitation techniques (sonic agitation, passive ultrasonic irrigation, and manual dynamic agitation [MDA]) in comparison with needle irrigation on postoperative pain in mandibular molar teeth with symptomatic irreversible pulpitis. One hundred sixty-eight patients with a single tooth diagnosed as symptomatic irreversible pulpitis were selected. Teeth were randomly assigned to 4 groups based on the final irrigation methods. In group 1 (needle irrigation), irrigation was conducted without agitation with a side-port needle; in group 2, sonic agitation was used; in group 3, passive ultrasonic irrigation was used; and in group 4, MDA was used. Teeth were then obturated with gutta-percha and a resin-based sealer using the cold lateral compaction technique. The presence of postoperative pain was assessed after 6, 24, 48, and 72 hours and 1 week. At the 6- and 24-hour time intervals, group 4 patients reported more intense postoperative pain than those patients in groups 1, 2, and 3 (P .05), and in all groups the intensity of postoperative pain decreased over time. MDA caused greater postoperative pain after endodontic therapy in mandibular molar teeth with symptomatic irreversible pulpitis compared with the other methods in the first 24 hours.