title: Postoperative pain intensity after using different instrumentation techniques: a randomized clinical study.
abstract: OBJECTIVE
  The aim of this clinical study was to evaluate the influence of the instrumentation techniques on the incidence and intensity of postoperative pain in single-visit root canal treatment.
  
  
  METHODS
  Ninety patients with single root/canal and non-vital pulps were included. The patients were assigned into 3 groups according to root canal instrumentation technique used; modified step-back, reciprocal, and rotational techniques. Root canal treatment was carried out in a single visit and the severity of postoperative pain was assessed via 4-point pain intensity scale. All the participants were called through the phone at 12, 24 and 48 h to obtain the pain scores. Data were analyzed through the Kruskal-Wallis test.
  
  
  RESULTS
  There was significant difference between all groups (p<0.05). The modified step-back technique produced postoperative pain significantly lower than the rotational (p=0.018) and reciprocal (p=0.020) techniques. No difference was found between the reciprocal and rotational techniques (p=0.868). Postoperative pain in the first 12 h period (p=0.763) and in the 24 h period (p=0.147) was not significantly different between the groups. However, the difference in the 48 h period was statistically different between the groups (p=0.040).
  
  
  CONCLUSIONS
  All instrumentation techniques caused postoperative pain. The modified step-back technique produced less pain compared to the rotational and reciprocal techniques.
authors.affiliation: Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey.
authors.forename: Ersan
authors.initials: E
authors.lastname: Çiçek
authors.affiliation: Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey.
authors.forename: Mustafa Murat
authors.initials: MM
authors.lastname: Koçak
authors.affiliation: Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Koçak
authors.affiliation: Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey.
authors.forename: Baran Can
authors.initials: BC
authors.lastname: Sağlam
authors.affiliation: Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey.
authors.forename: Sevinç Aktemur
authors.initials: SA
authors.lastname: Türker
mesh_terms: D000328:Adult; D000368:Aged; D003762:Dental Instruments / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D012390:Root Canal Therapy / Q000009:adverse effects* / Q000295:instrumentation*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult