Effect of Passive Ultrasonic Irrigation and Laser Disinfection in Single Visit Root Canal Therapy on Postoperative Pain

Abstract

Introduction: Postoperative pain is an unwanted common sensation after endodontic treatment. Postoperative discomfort affects anywhere from 3 to 58% of patients. Complete elimination of bacteria in the form of biofilm from the canals is very difficult. But there is no one unique irrigant that can meet all the requirements of ideal irrigant. Aim: To compare and evaluate the effect of Passive Ultrasonic Irrigation (PUI) and laser disinfection for postoperative pain and discomfort after a single visit root canal therapy in non vital single rooted teeth. Materials and Methods: This randomised clinical study was conducted on 44 patients, in the Department of Conservative Dentistry and Endodontics, KM Shah Dental College and Hospital, Vadodara, Gujarat, India, from July 2018 to December 2018. Administration of local anaesthetic agent (1:2,00,000 lignocaine with adrenaline) followed by isolation with rubber dam and access cavity preparation was done. Cleaning and shaping of the teeth were done. The patients were randomised into two groups using a flip coin procedure. In Group A, laser disinfection was done using 810 nm diode laser, 2 W power. In Group B, ultrasonic agitation with 5.25% of sodium hypochlorite (NaOCl) was done. Final irrigation with normal saline was done followed by obturation and postendodontic restoration using composite resin. Postendodontic evaluation was done by the blinded evaluator with help of modified verbal rating scale for 6 hours, 24 hours, 48 hours and 7 days. After evaluation, the data was collected and statistically analysed using Pearson’s Chi-square test with 5% level of significance using Statistical Package for the Social Sciences (SPSS) version 20.0. Results: Among 44 patients, 25 were male and 19 were female. The age of 10 patients was between 40-60 years, age of 28 patients was 30-40 years, while age of remaining 6 patients was between 18-29 years. The results showed no statistically significant difference in the postoperative pain and discomfort of PUI and laser disinfection when used for disinfection in a single visit root canal therapy (p-value= 0.086). Conclusion: Both PUI and laser disinfection are equally effective in reducing postoperative pain and discomfort after single visit root canal treatment. In the initial hours, laser disinfection has slightly higher edge over PUI.

Keywords

• necrosed teeth
• photodynamic therapy
• sodium hypochlorite