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Abstract
Objective: To compare inter-appointment pain reduction during root canal treatment in symptomatic apical periodontitis by using conventional irrigation and EndoActivator irrigation system.
Methodology: This randomized controlled trial enrolled 156 patients diagnosed with symptomatic apical periodontitis involving permanent mature single-rooted teeth that were randomly allocated into two equal groups at Department of Operative Dentistry and Endodontics, Isra University Hospital, Hyderabad, over one year following synopsis approval. Group A underwent conventional syringe irrigation, while Group B received EndoActivator irrigation. Pain intensity was recorded using the Visual Analog Scale preoperatively and postoperatively at 24 and 48 hours. Percentage inter-appointment pain reduction was calculated and compared between groups using independent samples t-test. Stratification by age, gender, and tooth type was performed, followed by post-stratification analysis. SPSS version 22 was used to analyse the data. A p-value of ≤0.05 was considered statistically significant.
Results: A total of 156 patients were included, with 78 participants in each group. The EndoActivator irrigation group demonstrated significantly greater percentage pain reduction than the conventional irrigation group at both 24 hours (82.01 ± 14.91 vs. 49.49 ± 12.22; p<0.001) and 48 hours (99.17 ± 4.22 vs. 82.64 ± 13.37; p<0.001). Statistically significant differences remained after stratification for age, gender, and most tooth types. In canine teeth, the difference remained statistically significant at 24 hours but not at 48 hours.
Conclusion: EndoActivator irrigation was associated with significantly greater inter-appointment pain reduction compared with conventional syringe irrigation during root canal treatment.