title: Pain following foraminal enlargement in mandibular molars with necrosis and apical periodontitis: A randomized controlled trial.
abstract: OBJECTIVE
  This randomized controlled trial was conducted to evaluate the effect of foraminal enlargement during chemomechanical root canal preparation on postoperative pain.
  
  
  METHODS
  Seventy mandibular first molars with asymptomatic pulp necrosis and chronic apical periodontitis were randomized into two groups - foraminal enlargement (FE) and conventional nonforaminal enlargement (NFE). Canals were prepared according to the respective protocols, and the teeth were restored temporarily. Postoperatively, the patients were prescribed ibuprofen 400 mg, to be taken if required. Pain experience and analgesic intake were recorded for 7 days following chemomechanical preparation. The data were analysed using Mann-Whitney U-test and chi-square tests.
  
  
  RESULTS
  Pain experience was higher with foraminal enlargement than when using a conventional technique. A significant difference was observed in postoperative pain during the first 4 days and the sixth day (P < 0.05), with greater pain in the FE as compared to the NFE group. There was no significant difference in prevalence of analgesic intake and number of doses between the experimental groups (P > 0.05).
  
  
  CONCLUSIONS
  Enlargement of the apical foramen during root canal treatment increased the incidence and intensity of postoperative pain.
authors.affiliation: Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India.
authors.forename: H R
authors.initials: HR
authors.lastname: Saini
authors.affiliation: Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India.
authors.forename: P
authors.initials: P
authors.lastname: Sangwan
authors.affiliation: Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India.
authors.forename: A
authors.initials: A
authors.lastname: Sangwan
mesh_terms: D000293:Adolescent; D000328:Adult; D003790:Dental Pulp Necrosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible; D008875:Middle Aged; D008963:Molar / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology* / Q000517:prevention & control; D010485:Periapical Periodontitis / Q000601:surgery*; D018915:Root Canal Preparation / Q000009:adverse effects / Q000379:methods*; D019227:Tooth Apex / Q000601:surgery*; D055815:Young Adult
keywords: apical periodontitis; endodontic treatment; foraminal enlargement; pain