Influence of different irrigant activation techniques in post-operative endodontic pain-A review of literature

Abstract

Introduction: Pain management during endodontic therapy has been a major concern among the dentists since many years. Patients often associate endodontic treatment with pain. The incidence of post-operative pain following root canal treatment is in the range of 3-58% [1, 2]. This review of literature analyzes the various irrigant activation techniques and their effectiveness in pain management. Materials and Methods: A search was performed in electronic database (i.e. PUBMED CENTRAL, Google and Hand Search) using following search terms alone and in combination by means of PUBMED search builder till March 2021. The various irrigant activation techniques were reviewed and all randomized clinical trials evaluating post operative pain following endodontic irrigation were analyzed. Results: Randomised clinical trials using irrigation activation techniques resulted in lesser post operative pain then conventional needle irrigation. Though manual dynamic agitation was capable of removing the vapor lock effect, it still had the tendency to push the irrigant beyond apex resulting in increased postoperative pain compared to other irrigation techniques. Conclusion: All the clinical studies concluded that irrigant activation with sonic, ultrasonic, laser activated irrigation and manual dynamic agitation produced lesser post operative pain. EndoVac which is a negative pressure irrigation system also proves to be better than conventional needle irrigation in terms of post operative pain.