Evaluation of post-operative pain and analgesic use after Endodontic Treatment in molars with and without forminal enlargment: prospective randomized clinical test

The aim of this study was to clinically evaluate the occurrence of postoperative pain and the use of analgesics after endodontic treatment of mandibular molars in a single session, using a reciprocating system, with or without foraminal enlargement in molars with necrosis and radiographically visible apical periodontitis. We selected 60 patients who presented lower molars with a diagnosis of asymptomatic necrosis confirmed by a negative response to heat and cold tests and radiographic evidence of apical periodontitis. The patients were randomly distributed into two groups through randomization by drawing lots according to the established working length: AF group, in which foraminal enlargement was performed, with the working length established at 0.0mm from the apex, and the SAF group, without enlargement foraminal, 1.0 mm below the apex. Both groups underwent an identical clinical protocol, performed by a single operator, with the exception of the established working length. The instrumentation was performed with the Wave One Gold system and the treatments were performed in a single session. Patients were instructed to classify, on a visual analogue scale, their pain as none, mild, moderate or severe after 24, 48, 72 hours and 7 days, as well as the need for oral medication for pain. The results were submitted to statistical tests of association and Student's t test (p>0.05). The comparison between the experimental groups for the sample characterization variables (age, gender and type of endodontically treated tooth) showed a similar distribution of the samples studied in the two experimental groups (p>0.05 for all comparisons), indicating that the experimental groups were compatible for the studied variables. The results showed that pain was statistically similar, both at 24h and 48h (p>0.05). At 72h and 7 days, no participant from any of the experimental groups reported pain. Despite the differences observed both at 24h and at 48h, there was no statistically significant difference in pain intensity between the experimental groups (p>0.05). There was no statistically significant difference in the comparison between the experimental groups for the amount of pills consumed for pain relief in any of the evaluated times. It was concluded that the incidence of postoperative pain and the amount of analgesic pills ingested were equivalent for both experimental groups