Comparative evaluation of postoperative pain after single visit endodontic treatment using ProTaper Universal and ProTaper Next rotary file systems: A randomized clinical trial

Introduction: Root canal preparation may cause inadvertent apical extrusion of debris causing postoperative pain. This debris varies with the instrumentation technique and design characteristics. One of the major revolutions in the design of the instruments is the introduction of files with an offset center of mass or/and rotation, which causes asymmetric rotary motion in the canal. An example is the ProTaper Next (PTN) rotary file system. In vitro studies have shown that this system extrudes lesser debris than more commonly used ProTaper Universal (PTU). However, in clinical circumstances, periapical tissues may act as a natural barrier and host immune response may affect the response. Hence, the aim of the present study was to evaluate and compare the postoperative pain after single visit endodontic treatment using PTU and PTN rotary file systems. Study Design: A total of 80 patients were assigned to two groups according to the root canal instrumentation technique used, PTU or PTN. Root canal treatment was carried out in a single appointment, and the severity of postoperative pain was assessed using visual analog scale score after 6, 24, 48, and 72 h. The association of variables (age and sex) and root canal preparation time were also evaluated and compared between the groups. Results: Postoperative pain was significantly higher in PTU group than PTN group. The highest pain was observed at 6 h interval which reduced with each time with no pain at 72 h interval in both the groups. Significantly, more amount of time was involved with PTU as compared to PTN. A significantly higher pain was observed with advancing age and in females. Conclusion: The postoperative pain was significantly higher in patients undergoing canal instrumentation with PTU rotary instruments as compared to the PTN rotary instruments.