The incidence and intensity of postoperative pain and Flare-up following the use of three different intracanal medicaments in teeth with posttreatment apical periodontitis: a randomized clinical trial
Objectives This randomized clinical trial aimed to compare the effect of intracanal medicaments on the incidence of postoperative pain and flare-up with posttreatment apical periodontitis (PTAP) of retreatment cases. Materials and methods One hundred twenty patients diagnosed with PTAP with single-r...
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| Veröffentlicht in: | Clinical oral investigations 2024-06, Vol.28 (7), p.362, Article 362 |
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| creator | Angın, Adile Esen Özkan, Hicran Dönmez Saral, İlkim Pınar Aydın, Berdan |
| description | Objectives
This randomized clinical trial aimed to compare the effect of intracanal medicaments on the incidence of postoperative pain and flare-up with posttreatment apical periodontitis (PTAP) of retreatment cases.
Materials and methods
One hundred twenty patients diagnosed with PTAP with single-rooted teeth with single-canal without spontaneous pain or swellings were included and randomly divided into three groups according to the intracanal medicament used. Intracanal medicaments were placed into the root canals following the removal of previous root canal fillings and re-instrumentation. Calcium hydroxide (Ca (OH)
2
), chlorhexidine gel (CHX), calcium hydroxide and chlorhexidine gel combinations were used as intracanal medicaments. Postoperative pain scores were recorded at 6 and 12 h and 1, 2, 3, 4, 5, 6, and 7 days using a visual analog scale (VAS). Sensitivity on percussion, spontaneous pain, swelling, antibiotic and analgesic requirements of the patients were evaluated during clinical examinations performed postoperatively after 2 and 7 days.
Results
There were no statistically significant differences between groups in terms of VAS scores following the intracanal medicament application (
p
> 0.05). However, compared to the patients of 20–34 and 50–65 age groups, greater VAS scores were observed in patients of 35–49 age groups at 12 h, and 3, 4, 7 days (
p
|
| doi_str_mv | 10.1007/s00784-024-05760-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11161537</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3065509415</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-d799f59b32c8b01b93107fdf70da732b9bf4bcd76ea9e49115048ba61fc9307b3</originalsourceid><addsrcrecordid>eNp9ks9u1DAQxiMEomXhBTggS1y4BOw4iWMuqKooIFXiUs6WY493XXntYDtdlSfksXA2pRQOHPx3fvONx_qq6iXBbwnG7F0q09DWuCmjYz2uD4-qU9LSvqaMkccP9ifVs5SuMSZtz-jT6oQOQ8v7rjutfl7tAFmvrAavAEmvyymDTzbfomDQFFIOE0SZ7Q2gSVp_ZC6cjFDPEzLBuXCwfotyEZoTLEl5FwGQtsZABJ8XxSiV9NKhPWir5L7cpnKNMkDeoYMt01IpR5B5CSI5FcyhUtkGHXy22ab3SKJYqoe9_QEaKWf9EcrRSve8emKkS_Dibt1U3y4-Xp1_ri-_fvpyfnZZK9r1udaMc9PxkTZqGDEZOSWYGW0Y1pLRZuSjaUelWQ-SQ8sJ6XA7jLInRnGK2Ug31YdVd5rH0oyCpTcnpmj3Mt6KIK34O-LtTmzDjSCE9KSjrCi8uVOI4fsMKYu9TQqckx7CnATFfccHSklT0Nf_oNdhjuUfV6rDvC2Sm6pZKRVDShHM_WsIFotTxOoUUZwijk4Rh5L06mEf9ym_rVEAugKphPwW4p_a_5H9BbdM0K0</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3065509415</pqid></control><display><type>article</type><title>The incidence and intensity of postoperative pain and Flare-up following the use of three different intracanal medicaments in teeth with posttreatment apical periodontitis: a randomized clinical trial</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Angın, Adile Esen ; Özkan, Hicran Dönmez ; Saral, İlkim Pınar ; Aydın, Berdan</creator><creatorcontrib>Angın, Adile Esen ; Özkan, Hicran Dönmez ; Saral, İlkim Pınar ; Aydın, Berdan</creatorcontrib><description>Objectives
This randomized clinical trial aimed to compare the effect of intracanal medicaments on the incidence of postoperative pain and flare-up with posttreatment apical periodontitis (PTAP) of retreatment cases.
Materials and methods
One hundred twenty patients diagnosed with PTAP with single-rooted teeth with single-canal without spontaneous pain or swellings were included and randomly divided into three groups according to the intracanal medicament used. Intracanal medicaments were placed into the root canals following the removal of previous root canal fillings and re-instrumentation. Calcium hydroxide (Ca (OH)
2
), chlorhexidine gel (CHX), calcium hydroxide and chlorhexidine gel combinations were used as intracanal medicaments. Postoperative pain scores were recorded at 6 and 12 h and 1, 2, 3, 4, 5, 6, and 7 days using a visual analog scale (VAS). Sensitivity on percussion, spontaneous pain, swelling, antibiotic and analgesic requirements of the patients were evaluated during clinical examinations performed postoperatively after 2 and 7 days.
Results
There were no statistically significant differences between groups in terms of VAS scores following the intracanal medicament application (
p
> 0.05). However, compared to the patients of 20–34 and 50–65 age groups, greater VAS scores were observed in patients of 35–49 age groups at 12 h, and 3, 4, 7 days (
p
< 0.05). Flare-up was observed in only one patient in the CHX gel group, and no flare-up was observed in other groups.
Conclusions
Similar postoperative pain incidence in all experimental groups indicates that all three medicaments are clinically acceptable in inter-appointment management of retreatment cases in terms of post-endodontic pain and flare-up.
Clinical relevance
In this randomized clinical trial, three different intracanal medicaments were utilized in nonsurgical endodontic retreatment and their effect on postoperative pain and flare-up incidence was examined. Thus, this study will be a significant contribution in the decision-making during clinical practice; since there are a limited number of prospective clinical trials in the literature about the severity of pain following retreatment procedures including intracanal medicament use.</description><identifier>ISSN: 1436-3771</identifier><identifier>ISSN: 1432-6981</identifier><identifier>EISSN: 1436-3771</identifier><identifier>DOI: 10.1007/s00784-024-05760-w</identifier><identifier>PMID: 38849655</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Age groups ; Analgesics ; Calcium hydroxide ; Calcium Hydroxide - therapeutic use ; Chlorhexidine ; Chlorhexidine - therapeutic use ; Clinical outcomes ; Clinical trials ; Decision making ; Dentistry ; Female ; Gum disease ; Humans ; Incidence ; Male ; Medicine ; Middle Aged ; Pain ; Pain management ; Pain Measurement ; Pain, Postoperative - drug therapy ; Periapical Periodontitis - surgery ; Periapical Periodontitis - therapy ; Periodontics ; Periodontitis ; Postoperative period ; Retreatment ; Root Canal Irrigants - therapeutic use ; Root Canal Therapy - methods ; Root canals ; Statistical analysis ; Teeth ; Treatment Outcome</subject><ispartof>Clinical oral investigations, 2024-06, Vol.28 (7), p.362, Article 362</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-d799f59b32c8b01b93107fdf70da732b9bf4bcd76ea9e49115048ba61fc9307b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00784-024-05760-w$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00784-024-05760-w$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38849655$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Angın, Adile Esen</creatorcontrib><creatorcontrib>Özkan, Hicran Dönmez</creatorcontrib><creatorcontrib>Saral, İlkim Pınar</creatorcontrib><creatorcontrib>Aydın, Berdan</creatorcontrib><title>The incidence and intensity of postoperative pain and Flare-up following the use of three different intracanal medicaments in teeth with posttreatment apical periodontitis: a randomized clinical trial</title><title>Clinical oral investigations</title><addtitle>Clin Oral Invest</addtitle><addtitle>Clin Oral Investig</addtitle><description>Objectives
This randomized clinical trial aimed to compare the effect of intracanal medicaments on the incidence of postoperative pain and flare-up with posttreatment apical periodontitis (PTAP) of retreatment cases.
Materials and methods
One hundred twenty patients diagnosed with PTAP with single-rooted teeth with single-canal without spontaneous pain or swellings were included and randomly divided into three groups according to the intracanal medicament used. Intracanal medicaments were placed into the root canals following the removal of previous root canal fillings and re-instrumentation. Calcium hydroxide (Ca (OH)
2
), chlorhexidine gel (CHX), calcium hydroxide and chlorhexidine gel combinations were used as intracanal medicaments. Postoperative pain scores were recorded at 6 and 12 h and 1, 2, 3, 4, 5, 6, and 7 days using a visual analog scale (VAS). Sensitivity on percussion, spontaneous pain, swelling, antibiotic and analgesic requirements of the patients were evaluated during clinical examinations performed postoperatively after 2 and 7 days.
Results
There were no statistically significant differences between groups in terms of VAS scores following the intracanal medicament application (
p
> 0.05). However, compared to the patients of 20–34 and 50–65 age groups, greater VAS scores were observed in patients of 35–49 age groups at 12 h, and 3, 4, 7 days (
p
< 0.05). Flare-up was observed in only one patient in the CHX gel group, and no flare-up was observed in other groups.
Conclusions
Similar postoperative pain incidence in all experimental groups indicates that all three medicaments are clinically acceptable in inter-appointment management of retreatment cases in terms of post-endodontic pain and flare-up.
Clinical relevance
In this randomized clinical trial, three different intracanal medicaments were utilized in nonsurgical endodontic retreatment and their effect on postoperative pain and flare-up incidence was examined. Thus, this study will be a significant contribution in the decision-making during clinical practice; since there are a limited number of prospective clinical trials in the literature about the severity of pain following retreatment procedures including intracanal medicament use.</description><subject>Adult</subject><subject>Age groups</subject><subject>Analgesics</subject><subject>Calcium hydroxide</subject><subject>Calcium Hydroxide - therapeutic use</subject><subject>Chlorhexidine</subject><subject>Chlorhexidine - therapeutic use</subject><subject>Clinical outcomes</subject><subject>Clinical trials</subject><subject>Decision making</subject><subject>Dentistry</subject><subject>Female</subject><subject>Gum disease</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Pain</subject><subject>Pain management</subject><subject>Pain Measurement</subject><subject>Pain, Postoperative - drug therapy</subject><subject>Periapical Periodontitis - surgery</subject><subject>Periapical Periodontitis - therapy</subject><subject>Periodontics</subject><subject>Periodontitis</subject><subject>Postoperative period</subject><subject>Retreatment</subject><subject>Root Canal Irrigants - therapeutic use</subject><subject>Root Canal Therapy - methods</subject><subject>Root canals</subject><subject>Statistical analysis</subject><subject>Teeth</subject><subject>Treatment Outcome</subject><issn>1436-3771</issn><issn>1432-6981</issn><issn>1436-3771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9ks9u1DAQxiMEomXhBTggS1y4BOw4iWMuqKooIFXiUs6WY493XXntYDtdlSfksXA2pRQOHPx3fvONx_qq6iXBbwnG7F0q09DWuCmjYz2uD4-qU9LSvqaMkccP9ifVs5SuMSZtz-jT6oQOQ8v7rjutfl7tAFmvrAavAEmvyymDTzbfomDQFFIOE0SZ7Q2gSVp_ZC6cjFDPEzLBuXCwfotyEZoTLEl5FwGQtsZABJ8XxSiV9NKhPWir5L7cpnKNMkDeoYMt01IpR5B5CSI5FcyhUtkGHXy22ab3SKJYqoe9_QEaKWf9EcrRSve8emKkS_Dibt1U3y4-Xp1_ri-_fvpyfnZZK9r1udaMc9PxkTZqGDEZOSWYGW0Y1pLRZuSjaUelWQ-SQ8sJ6XA7jLInRnGK2Ug31YdVd5rH0oyCpTcnpmj3Mt6KIK34O-LtTmzDjSCE9KSjrCi8uVOI4fsMKYu9TQqckx7CnATFfccHSklT0Nf_oNdhjuUfV6rDvC2Sm6pZKRVDShHM_WsIFotTxOoUUZwijk4Rh5L06mEf9ym_rVEAugKphPwW4p_a_5H9BbdM0K0</recordid><startdate>20240608</startdate><enddate>20240608</enddate><creator>Angın, Adile Esen</creator><creator>Özkan, Hicran Dönmez</creator><creator>Saral, İlkim Pınar</creator><creator>Aydın, Berdan</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240608</creationdate><title>The incidence and intensity of postoperative pain and Flare-up following the use of three different intracanal medicaments in teeth with posttreatment apical periodontitis: a randomized clinical trial</title><author>Angın, Adile Esen ; Özkan, Hicran Dönmez ; Saral, İlkim Pınar ; Aydın, Berdan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-d799f59b32c8b01b93107fdf70da732b9bf4bcd76ea9e49115048ba61fc9307b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Age groups</topic><topic>Analgesics</topic><topic>Calcium hydroxide</topic><topic>Calcium Hydroxide - therapeutic use</topic><topic>Chlorhexidine</topic><topic>Chlorhexidine - therapeutic use</topic><topic>Clinical outcomes</topic><topic>Clinical trials</topic><topic>Decision making</topic><topic>Dentistry</topic><topic>Female</topic><topic>Gum disease</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medicine</topic><topic>Middle Aged</topic><topic>Pain</topic><topic>Pain management</topic><topic>Pain Measurement</topic><topic>Pain, Postoperative - drug therapy</topic><topic>Periapical Periodontitis - surgery</topic><topic>Periapical Periodontitis - therapy</topic><topic>Periodontics</topic><topic>Periodontitis</topic><topic>Postoperative period</topic><topic>Retreatment</topic><topic>Root Canal Irrigants - therapeutic use</topic><topic>Root Canal Therapy - methods</topic><topic>Root canals</topic><topic>Statistical analysis</topic><topic>Teeth</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Angın, Adile Esen</creatorcontrib><creatorcontrib>Özkan, Hicran Dönmez</creatorcontrib><creatorcontrib>Saral, İlkim Pınar</creatorcontrib><creatorcontrib>Aydın, Berdan</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical oral investigations</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Angın, Adile Esen</au><au>Özkan, Hicran Dönmez</au><au>Saral, İlkim Pınar</au><au>Aydın, Berdan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The incidence and intensity of postoperative pain and Flare-up following the use of three different intracanal medicaments in teeth with posttreatment apical periodontitis: a randomized clinical trial</atitle><jtitle>Clinical oral investigations</jtitle><stitle>Clin Oral Invest</stitle><addtitle>Clin Oral Investig</addtitle><date>2024-06-08</date><risdate>2024</risdate><volume>28</volume><issue>7</issue><spage>362</spage><pages>362-</pages><artnum>362</artnum><issn>1436-3771</issn><issn>1432-6981</issn><eissn>1436-3771</eissn><abstract>Objectives
This randomized clinical trial aimed to compare the effect of intracanal medicaments on the incidence of postoperative pain and flare-up with posttreatment apical periodontitis (PTAP) of retreatment cases.
Materials and methods
One hundred twenty patients diagnosed with PTAP with single-rooted teeth with single-canal without spontaneous pain or swellings were included and randomly divided into three groups according to the intracanal medicament used. Intracanal medicaments were placed into the root canals following the removal of previous root canal fillings and re-instrumentation. Calcium hydroxide (Ca (OH)
2
), chlorhexidine gel (CHX), calcium hydroxide and chlorhexidine gel combinations were used as intracanal medicaments. Postoperative pain scores were recorded at 6 and 12 h and 1, 2, 3, 4, 5, 6, and 7 days using a visual analog scale (VAS). Sensitivity on percussion, spontaneous pain, swelling, antibiotic and analgesic requirements of the patients were evaluated during clinical examinations performed postoperatively after 2 and 7 days.
Results
There were no statistically significant differences between groups in terms of VAS scores following the intracanal medicament application (
p
> 0.05). However, compared to the patients of 20–34 and 50–65 age groups, greater VAS scores were observed in patients of 35–49 age groups at 12 h, and 3, 4, 7 days (
p
< 0.05). Flare-up was observed in only one patient in the CHX gel group, and no flare-up was observed in other groups.
Conclusions
Similar postoperative pain incidence in all experimental groups indicates that all three medicaments are clinically acceptable in inter-appointment management of retreatment cases in terms of post-endodontic pain and flare-up.
Clinical relevance
In this randomized clinical trial, three different intracanal medicaments were utilized in nonsurgical endodontic retreatment and their effect on postoperative pain and flare-up incidence was examined. Thus, this study will be a significant contribution in the decision-making during clinical practice; since there are a limited number of prospective clinical trials in the literature about the severity of pain following retreatment procedures including intracanal medicament use.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38849655</pmid><doi>10.1007/s00784-024-05760-w</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Age groups Analgesics Calcium hydroxide Calcium Hydroxide - therapeutic use Chlorhexidine Chlorhexidine - therapeutic use Clinical outcomes Clinical trials Decision making Dentistry Female Gum disease Humans Incidence Male Medicine Middle Aged Pain Pain management Pain Measurement Pain, Postoperative - drug therapy Periapical Periodontitis - surgery Periapical Periodontitis - therapy Periodontics Periodontitis Postoperative period Retreatment Root Canal Irrigants - therapeutic use Root Canal Therapy - methods Root canals Statistical analysis Teeth Treatment Outcome |
| title | The incidence and intensity of postoperative pain and Flare-up following the use of three different intracanal medicaments in teeth with posttreatment apical periodontitis: a randomized clinical trial |
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