Effect of Passive Ultrasonic Irrigation on Post operative pain in controlled diabetic patients after non surgical Endodontic treatment of teeth - A randomised controlled trial

´The incidence of postoperative pain after endodontic treatment ranges from 1.9%-48%. This pain is often attributed to periapical inflammatory responses which typically subsided over time but occasionally persisting for several days.

´Two factors that affect the postoperative pain are:

1. During pulp necrosis, the bacterial toxins and immunological agents reach the peri radicular tissues leading to apical periodontitis (AP).

2. There are some systemic conditions that increases the susceptibility of the host to infection thereby increasing microorganisms in AP.

´It is important to consider these factors in order to ensure effective implementation of pain management strategies in the context of endodontic interventions.

´Animal and epidemiological studies have provided the data suggesting that several systemic conditions like diabetes, cardiovascular diseases, smoking, menopause, HIV and others can substantially influence the prognosis of endodontic treatment.

´Most common systemic factor affecting post-operative pain is Diabetes Mellitus affecting more than 9% of the population.

´Several etiologic factors are attributed to postoperative pain (PP) including a history of preoperative pain, periapical disease, and extrusion of debris and/or irrigation solution into the periapical tissue.

´Materials extruded into the periapical tissue have been suggested as a major source of pain after RCT. It has been stated that irrigation methodologies and devices have an effect on apical extrusion of debris and irrigants.

´Several studies have evaluated the healing outcomes and post operative pain in diabetic patients but so far no study has evaluated the effect of passive ultrasonic irrigation on post operative pain of diabetic patients after endodontic treatment of teeth with symptomatic apical periodontitis.