title: Postoperative pain after foraminal enlargement in anterior teeth with necrosis and apical periodontitis: a prospective and randomized clinical trial.
abstract: BACKGROUND
  The aim of this randomized, controlled, prospective clinical study was to determine if foraminal enlargement instrumentation during endodontic treatment is associated with more postoperative pain compared with standard nonenlargement instrumentation.
  
  
  METHODS
  Forty volunteers with a single root canal were diagnosed with asymptomatic necrosis with apical periodontitis and randomized into 2 experimental groups (ie, the control group and the foraminal enlargement group). Endodontic treatment was performed in a single visit, and volunteers were instructed to record pain intensity (ie, none, slight, moderate, and severe). Scores from 1 to 4 were attributed to each kind of pain after 12, 24, and 48 hours. The Kolmogorov-Smirnov and Student's t tests were used to determine significant differences at P < .05.
  
  
  RESULTS
  No statistically significant age difference was found between the groups (P > .05, Student's t test). Postoperative pain showed no statistically significant difference between the groups at any observation period (P > .05). Also, no significant difference was observed in the mean number of analgesic tablets used between the groups (P > .05).
  
  
  CONCLUSIONS
  The foraminal enlargement and nonenlargement techniques resulted in the same postoperative pain and necessity for analgesic medication. This may suggest that the use of foraminal enlargement should be performed for endodontic treatment previsibility without increasing postoperative pain.
authors: Department of Endodontics, Rio de Janeiro State University, Rio de Janeiro, Brazil. nogueiraemmanuel@hotmail.com
authors: Emmanuel João Nogueira Leal
authors: EJ
authors: Silva
authors: Karyne
authors: K
authors: Menaged
authors: Natasha
authors: N
authors: Ajuz
authors: Maria Rachel Figueiredo Penalva
authors: MR
authors: Monteiro
authors: Tauby de Souza
authors: Tde S
authors: Coutinho-Filho
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D058070:Asymptomatic Diseases; D003786:Dental Pulp Cavity / Q000473:pathology / Q000601:surgery*; D003790:Dental Pulp Necrosis / Q000628:therapy*; D003791:Dental Pulp Test; D005260:Female; D005500:Follow-Up Studies; D006171:Gutta-Percha / Q000627:therapeutic use; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D010485:Periapical Periodontitis / Q000628:therapy*; D011446:Prospective Studies; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D012388:Root Canal Irrigants / Q000627:therapeutic use; D012389:Root Canal Obturation / Q000379:methods; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods*; D012973:Sodium Hypochlorite / Q000627:therapeutic use; D019227:Tooth Apex / Q000473:pathology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D006171:Gutta-Percha; D012973:Sodium Hypochlorite; D007052:Ibuprofen