Comparison of ultrasonic versus side-vented needle irrigation for reductions in bacterial growth and postoperative pain: A randomized controlled trial

Postoperative pain affects 16%-25% of root canal therapy patients. The irrigating system and irrigants used should reduce bacterial load without irrigant extrusion beyond the root canal apex, potentially reducing postoperative pain and discomfort. This study aims to compare the effects of passive ultrasonic irrigation and side-vented needle irrigation on postoperative pain and bacterial load in single-rooted teeth with pulp necrosis. Eighty patients with pulpal necrosis in single-rooted teeth were randomly categorized into two groups ( = 40 each): Group A (side-vented needle irrigation) and Group B (passive ultrasonic irrigation). Bacterial samples were collected using sterile paper points after initial access cavity preparation (S1) and standard endodontic instrumentation + irrigation (S2). Bacterial growth was assessed on MacConkey and blood agar. Pain was recorded 30 min preoperatively and 6, 12, 24, and 48 h postoperatively. Chi-square test, independent t-test and paired t-test. Irrigation with Irrisafe tips showed increased number of bacteria-free samples and a significant reduction in postoperative pain (at the 6 and 12 h time-points) when compared to side-vented needle. Passive ultrasonic irrigation with Irrisafe tips may be more effective than side-vented needle irrigation in reducing postoperative pain and intracanal bacterial load in patients undergoing endodontic treatment.