Incidence of Postoperative Pain After Root Canal Preparation Using Three Different Instruments

In the study, 180 patients who were diagnosed with asymptomatic irreversible pulpitis, symptomatic irreversible pulpitis, acute apical periodontitis and chronic apical periodontitis, and who applied to the Endodontics clinic for inclusion in the endodontics clinic will be included. A female with systemic healthy patients who meet the inclusion criteria will be treated clinically and radiologically. The age and gender of the patient will be recorded as patient-dependent variables, and location and type of the tooth to be treated will be recorded as tooth-dependent variables. Before the root canal treatment, the responsible researcher will provide training on patients with the Vizual Analog Scale (VAS) and its use. Root canal treatments will be completed by this responsible investigator. Before starting root canal treatment, local anesthesia will be applied using 2: Lidocaine anesthetic solution containing 2: 80,000 epinephrine using the appropriate technique to the tooth. After anesthesia is provided, endodontic access cavities suitable for the teeth will be opened. The pulp tissue will be extruded using a turner. Subsequently, according to the entry path file to be used, the subjects will be assigned to the group that is selected from the closed envelopes that write the names of the groups, and random manual preparation will be divided into 3 groups: the R-Pilot file will be used, the rotation preparation will be used, and the ProGlider file will be used (n = 60). Working lengths will be determined by using K type file 10 and electronic apex finders. The manual preparation group will serve as the control group. In this group, K type hand files (Dentsply Sirona) # 08, 10, 15, respectively, will be used with the "forward and retract" technique proposed by Ruddle at the working length. The file will be moved clockwise and then counterclockwise, by rotating quarterly, the resistance will be advanced and retracted to the point where resistance is felt in the canal. This preparation will be made with each file until the working length is reached. In the rotation group where ProGlider file will be used, the entry way will be prepared at 300 rpm and 5 Ncm torque values using the torque-controlled endodontic motor (X-Smart) until the working length is reached with the crown-down technique. In the reciprocating movement group where the R-Pilot file will be used, the entry path will be prepared using the "Reciproc All" mode in the VDW-Silver endodontic engine. After the entryway preparation, standard procedures will be performed for all three groups. The channels will be prepared with ProTaper Next file system. During treatment, 10 mL of 5% NaOCl irrigation for each channel will be done using a 30-G irrigation needle. After the preparation, final irrigation will be done with 17% EDTA, distilled water and 5% NaOCl, respectively. In the samples in all three groups, after the root canals are dried with sterile paper cone, they will be filled with cold Plus lateral compaction technique with AH Plus canal paste and gutta percha cone. Patients' phone numbers will be taken, a copy of the VAS form will be delivered to the patients to be filled in, and it will be explained that postoperative pain measurements will be made with 6, 12, 18, 24, 36 and 48 hours of VAS. Patients will be reached by phone 48 hours after the completion of root canal treatments and information about their pain levels will be received. VAS values will be classified as follows: 0, no pain; 1-3, mild pain; 4-6, moderate pain; 7-10, severe pain. The use of analgesics will also be evaluated and recorded within the first 48 hours.