title: Influence of Rotary Instrumentation with Continuous Irrigation on Pain and Neuropeptide Release Levels: A Randomized Clinical Trial.
abstract: BACKGROUND
  The first objective was to determine correlation among various experimental and clinical pain measurement procedures. The second objective was to evaluate the influence of rotary instrumentation with continuous irrigation on pain and neuropeptide release levels.
  
  
  METHODS
  Forty patients who had preoperative pain at the levels of 3-8 on the visual analogue scale were included. Gingival crevicular fluid (GCF) samples were collected. Patients were randomly assigned to 2 treatment groups, the standard preparation group and the preparation with continuous irrigation group. Apical fluid samples (AFS) were collected after instrumentation. In the second visit, the patients' pain levels were recorded, and GCF and AFS were obtained. Substance P, calcitonin-gene related peptide (CGRP), interleukin (IL)-1β, and IL-10 levels were analyzed from the GCF and AFS samples. For comparison between groups, the Mann-Whitney test was used (P < .05).
  
  
  RESULTS
  In terms of clinical data, no significant difference was detected in the first and second sessions between groups. The IL-10 level obtained from AFS significantly decreased in the second session in both groups (P < .001). Visual analogue scale scores of spontaneous pain correlated with percussion pain positively (r = 0.718, P < .001). CGRP (GCF) (second session) and IL-10 (GCF) (second session) positively correlated with percussion pain (r = 0.425, P < .01) (r = 0.379, P < .05).
  
  
  CONCLUSIONS
  Rotary preparation with continuous irrigation has not been more effective than the standard preparation method for reducing pain. Because of determination of the correlation between CGRP and IL-10 with percussion pain, these neuropeptides can be used in further studies.
authors: Private Practice, İzmir, Turkey.
authors: Hazal
authors: H
authors: Bıçakcı
authors: Private Practice, Istanbul, Turkey. Electronic address: capardt@hotmail.com.
authors: İsmail Davut
authors: İD
authors: Çapar
authors: Department of Periodontology, Faculty of Dentistry, İzmir Katip Çelebi University, İzmir, Turkey.
authors: Selin
authors: S
authors: Genç
authors: Department of Biochemistry and Clinical Biochemistry, School of Medicine, İzmir Katip Çelebi University, İzmir, Turkey.
authors: Alperen
authors: A
authors: İhtiyar
authors: Private Practice, İzmir, Turkey.
authors: Recep
authors: R
authors: Sütçü
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005883:Gingival Crevicular Fluid / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009479:Neuropeptides / Q000378:metabolism*; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management / Q000379:methods*; D012388:Root Canal Irrigants / Q000008:administration & dosage*; D018915:Root Canal Preparation / Q000295:instrumentation* / Q000379:methods; D012390:Root Canal Therapy / Q000295:instrumentation* / Q000379:methods; D055815:Young Adult
chemical_list: D009479:Neuropeptides; D012388:Root Canal Irrigants
keywords: Endodontics; instrumentation with continuous irrigation; neuropeptide; pain; rotary instruments