Influence of three Ni–Ti cleaning and shaping files on postinstrumentation endodontic pain: A triple-blinded, randomized, controlled trial

AIM: This randomized, controlled trial evaluated the incidence of postinstrumentation pain on using two different rotary Ni–Ti and one reciprocating Ni–Ti cleaning and shaping systems. MATERIALS AND METHODS: Asfter sample size estimation, a total of 152 patients were randomized to three groups (Group WO [WaveOne], Group PU [ProTaper Universal], and Group Mt [Mtwo]). Selection of patients was based on root curvature, periapical lesion, vitality, gender, and diagnosis of the patient. A similar clinical protocol was followed and endodontic treatment was performed. Pre- and post-instrumentation pain scores (2, 4, 6, 8, 12, 36, and 48 h) were recorded using visual analog scale score. Kruskal–Wallis test was done for overall comparison of the groups. Bonferroni-corrected Mann–Whitney test was done for pair-wise comparisons and Friedman test was done to compare pain between time points in each file system (P < 0.05). RESULTS: All preinstrumentation pain values were higher than postinstrumentation pain values (P < 0.05). At 48 h, patients in Group WO experienced more pain compared to the other two groups. Pain scores of nonvital teeth were significantly higher when compared to vital teeth. Among nonvital teeth, patients in Group WO had early onset of pain at 6 h and lasted till 48 h, whereas pain started at 12 h and lasted till 36 and 48 h for Group Mt and Group PU, respectively. CONCLUSION: Patients treated with WaveOne files experienced more pain when compared to the other files. Nonvital teeth experienced more pain compared to vital teeth. Group Mt had the lowest postinstrumentation pain.