Pain after single visit endodontic treatment using fifth generation file systems -An invivo study

Aim: To compare the incidence, duration and severity of pain after single visit root canal treatment with three different fifth generation file systems (ProTaper Next, One Shape, and Revo-S). Materials and Method: Three groups, each consisting of 45 patients with symptomatic irreversible pulpitis and symptomatic peri-apical periodontitis were selected and instrumented. Group I (n = 45) was instrumented with ProTaper Next file system, Group II (n = 45) was instrumented using One Shape file system and Group III (n = 45) was instrumented using Revo-S file system. All canals were instrumented and obturated in the same visit, following treatment patients were discharged with a questionnaire to gather data about the incidence (yes/no), severity (mild, moderate or severe), and duration of pain (days). Postoperative pain response of patients was evaluated at 6, 12, 24 and 48 hrs, using the visual analogue scale (VAS) score. The severity and incidence of pain between groups were compared using the chi-squared test. The statistical significance of differences were estimated by one way ANOVA and post hoc Tukey test, P< 0.05 was considered as significant. Results: Highest mean pain (1.378 ± 0.49) was seen in group II, 12 hr post-operatively, while lowest mean pain (0.067 ± 0.25) was seen 48 hr post-operatively in group III. There was highly significant difference (P<0.001) in pain between the group I & II (at 24 hours and 48 hours), group II & III (at 6, 12, 24 and 48 hours) and group I & III (at 6 & 12 hours), of post-operative sessions. Group III had lowest mean pain. There was statistically significant difference (P<0.001) in intensity of pain between the groups I, II & III at 6 hours, 12 hours, 24 hours & 48 hours. Conclusion: Tooth instrumented with Revo-S file system were found to be least associated with incidence, duration and severity of postoperative pain at the time points assessed.