Objective: This double-blinded randomized clinical trial aimed to compare postoperative pain using 2Shape® (TS) in rotary (TSRot) and adaptive (TSAK) kinematics in the maxillary and mandibular molars in patients with symptomatic irreversible pulpitis and symptomatic apical periodontitis following single-visit endodontic treatment.
Methods: Seventy patients were randomly assigned to two groups (TSRot /TSAK), (n=35 each). The preoperative and postoperative pain intensities at various time intervals up to 72h using a Visual-Analogue Scale was noted. Mann-Whitney U test (p<0.05*) was used to compare pain intensity, and the chi-square test was used to compare the incidence of pain. Dunns test (p<0.05*) was used for intragroup comparisons. Binary logistic regression was performed at consecutive time intervals.
Results: A total of 67 patients were included in the final analysis, and three were excluded due to medication intake. Both groups showed a gradual reduction in the mean incidence and intensity of postoperative pain from 6 to 72 hours. However, TSAK had a significantly lower intensity and incidence of pain than TSRot at 24h (p=0.02*). There was no statistically significant difference observed in the duration of instrumentation when the TS file was used in either adaptive or rotary kinematics (p=0.41).
Conclusion: Adaptive kinematics (TSAK) resulted in less pain incidence compared with rotary kinematics (TS-Rot). A statistically significant difference in incidence was observed at 24 h but may not be clinically significant. The duration of instrumentation was similar between the TSRot and TSAK groups. Thus, the 2Shape® (TS) file, which is a rotary file, can be used in adaptive kinematics to reduce the postoperative pain. (EEJ-2024-02-036).