Comparison of Postoperative Pain in Root Canal Treatment by Using Sodium Hypochlorite and Chlorhexidine-based Root Canal Irrigants

Tabassum  Naz; Irfan Ullah  Khan; Ahsan Ali  Khan; Mashal Zeb  Jan; Momina  Illiyeen; Sidra  Gul; Tehreema  Naureen; Suhaib  Ahmed

doi:10.54112/bcsrj.v6i4.2136

Authors

Tabassum Naz Department of Operative Dentistry and Endodontics, Rahman Medical Institute, Peshawar, Pakistan
Irfan Ullah Khan Department of Operative Dentistry and Endodontics, Rahman Medical Institute, Peshawar, Pakistan
Ahsan Ali Khan Department of Operative Dentistry and Endodontics, Rahman Medical Institute, Peshawar, Pakistan
Mashal Zeb Jan Department of Operative Dentistry and Endodontics, Rahman Medical Institute, Peshawar, Pakistan
Momina Illiyeen Department of Operative Dentistry and Endodontics, Rahman Medical Institute, Peshawar, Pakistan
Sidra Gul Department of Operative Dentistry and Endodontics, Rahman Medical Institute, Peshawar, Pakistan
Tehreema Naureen Department of Operative Dentistry and Endodontics, Rahman Medical Institute, Peshawar, Pakistan
Suhaib Ahmed Department of Operative Dentistry and Endodontics, Rahman Medical Institute, Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i4.2136

Keywords:

Postoperative pain, Root canal irrigation, Sodium hypochlorite, Chlorhexidine, Irreversible pulpitis, Visual Analogue Scale.

Abstract

Postoperative pain following root canal treatment remains a common clinical concern and may be influenced by the type of irrigant used during the procedure. Objective: To compare the frequency of postoperative pain observed in root canal treatment by using sodium hypochlorite and chlorhexidine-based root canal irrigants. Methods: This study was conducted on 168 patients diagnosed with irreversible pulpitis in posterior teeth who underwent root canal treatment, and were allocated via lottery into two equal groups. Group A received irrigation with 5.25% sodium hypochlorite, while Group B received 2% chlorhexidine. Postoperative pain was evaluated in both groups using a 10-point Visual Analogue Scale (VAS), with a score of ≥3 indicating significant pain at 45 days after treatment. SPSS 23 was used for analysing the data. Results: Postoperative pain was reported significantly more frequently in the sodium hypochlorite group, with 26 (31.0%) cases experiencing pain, compared with 13 patients (15.5%) in the chlorhexidine group (p=0.01). The incidence of postoperative swelling was 10.7% in Group A and 4.8% in Group B. Postoperative bleeding was observed in 8.3% and 6.0% cases, respectively, in both groups. Conclusion: The present study found that the frequency of pain was lower in root canal treatment with chlorhexidine as the root canal irrigant compared with sodium hypochlorite.

Downloads

Download data is not yet available.

References

Peters OA, Peters CI, Basrani B. Cleaning and shaping of the root canal system. In: Berman LH, Hargreaves KM, editors. Cohen’s Pathways of the Pulp. 12th ed. Elsevier; 2020. p. 236-303. https://doi.org/10.1016/B978-0-323-06489-7.00009-6

Di Spirito F, Pisano M, Caggiano M, Bhasin P, Lo Giudice R, Abdellatif D. Root canal cleaning after different irrigation techniques: an ex vivo analysis. Medicina. 2022;58(2):193. https://doi.org/10.3390/medicina58020193

Qutieshat A, Al Harthy N, Al Busaidi S, Al Sadoon A, Al Sayahien D, Sedqi M, et al. Antimicrobial irrigation solutions in root canal treatment: a glance at the past, the present, and the future. Open Dent J. 2023;17(1):e187421062306010. https://doi.org/10.2174/18742106-v17-230621-2023-5

Darcey J, Jawad S, Taylor C, Roudsari RV, Hunter M. Modern endodontic principles part 4: irrigation. Dent Update. 2016;43(1):20-33. https://doi.org/10.12968/denu.2016.43.1.20

Rahimi S, Janani M, Lotfi M, Shahi S, Aghbali A, Vahid Pakdel M, et al. A review of antibacterial agents in endodontic treatment. Iran Endod J. 2014;9(3):161-168.

Almeida G, Marques E, De Martin AS, da Silveira Bueno CE, Nowakowski A, Cunha RS. Influence of irrigating solution on postoperative pain following single-visit endodontic treatment: randomized clinical trial. J Can Dent Assoc. 2012;78:c84.

Bashetty K, Hegde J. Comparison of 2% chlorhexidine and 5.25% sodium hypochlorite irrigating solutions on postoperative pain: a randomized clinical trial. Indian J Dent Res. 2010;21(4):523-527. https://doi.org/10.4103/0970-9290.74225

Borgo Sarmento E, Guimarães L, Tavares S, Thuller KABR, Antunes L, Antunes L, et al. The influence of sodium hypochlorite and chlorhexidine on postoperative pain in necrotic teeth: a systematic review. Eur Endod J. 2020;5(3):177-185. https://doi.org/10.14744/eej.2020.94830

Neelakantan P, Herrera DR, Pecorari VGA, Gomes BPFA. Endotoxin levels after chemomechanical preparation of root canals with sodium hypochlorite or chlorhexidine: a systematic review of clinical trials and meta-analysis. Int Endod J. 2019;52(1):19-27. https://doi.org/10.1111/iej.12963

Saba K, Maxood A, Abdullah S, Riaz A, Uddin S. Comparison of frequency of pain in root canal treatment using sodium hypochlorite and chlorhexidine as root canal irrigants. J Pak Med Assoc. 2018;68(9):1334-1338.

Amjad S, Afreen Z, Afreen A, Shuja E, Rasheed H, Rashid S. Comparison of pain observed with sodium hypochlorite and chlorhexidine-based root canal irrigant 24 hours post appointment. J Rawalpindi Med Coll. 2022;26(4):594-599. https://doi.org/10.37939/jrmc.v26i4.1932

Qazi SS, Manzoor MA, Qureshi R, Khan HH. Comparison of postoperative pain: normal saline vs sodium hypochlorite as irrigants. Pak Oral Dent J. 2005;25(2):177-182.

Gomes BPFA, Martinho FC, Vianna ME. Comparison of 2.5% sodium hypochlorite and 2% chlorhexidine gel on oral bacterial lipopolysaccharide reduction from primarily infected root canals. J Endod. 2009;35(10):1350-1353. https://doi.org/10.1016/j.joen.2009.06.011