Postoperative pain and quality of life assessment after endodontic preparation with rotary and reciprocating endodontic instruments: randomized clinical trial

Background : Post-operative pain is a common complication following endodontic treatment, often caused by acute inflammatory responses in periapical tissues. Several factors contribute to this, including inadequate instrumentation, apical extrusion of debris during canal preparation, and other aspects of the procedure. Advances in technology have led to the development of nickel-titanium (NiTi) instruments, which have shown potential to reduce post-operative discomfort. This study aims to evaluate post-operative pain in patients undergoing endodontic treatment with different NiTi systems. Method : This randomized clinical trial will include 128 patients aged between 18 and 50 years with a diagnosis of pulp alterations in molars without pain or radiographic lesions requiring endodontic treatment. Patients will be randomly allocated to receive root canal preparation with the rotary ProTaper Ultimate system or the reciprocating single-file Reciproc Blue system. The primary outcome will be the intensity of post-operative pain measured using a numerical rating scale (NRS-10 cm) and a visual analog scale (VAS-0-10 cm) at 6, 12, and 24 hours post-operatively. Secondary outcomes will include spontaneous pain, occlusion sensitivity, and quality of life, assessed through the OHIP-14 questionnaire. Discussion : Our hypothesis is that there will be no differences in pain performance between the different systems, but there will be improvements in quality of life. The results of this study will provide information on the incidence and intensity of post-operative pain after instrumentation of root canals with different NiTi systems and may help improve outcomes and quality of life for patients. Trial registration : Brazilian Clinical Trials Registry (REBEC): RBR-10kbw6nx. Registered on April 6, 2024.