COMPARISON OF POST-OPERATIVE PAIN USING TWO INSTRUMENTATION TECHNIQUES FOLLOWED BY LASER IRRADIATION IN NON-VITAL TEETH WITH SYMPTOMATIC APICAL PERIODONTITIS: A RANDOMIZED CONTROLLED TRIAL

Pain management is one of the mostimportant aspects of endodontic treatment. Infected root canals are the mostcommon cause of endodontic pain. Apical extrusion of debris is a drawbackof all endodontic instrumentation techniques. This can result in post-operativepain and discomfort due to inflammation of periapical tissues. It is generally accepted that crown downtechnique and balanced force technique cause less apical extrusion of debrisand hence lesser post-operative pain. In earlier studies related to lasers, theuse of lasers was limited to treating dentinal hypersensitivity, for itseffects on vital pulpotomy, and for evaluating postoperative pain and swellingin patient undergoing extractions of impacted 3rd molar. Use of lasers after chemo-mechanicalpreparation have been shown in some studies to affect pain outcomes favourably.However, the crown down technique for NiTihas several drawbacks such as file breakage, poor dentin conservation(predisposing to vertical root fractures) and high recurring cost. According to our literature search, post-operativepain due to debris extrusion with k400 reciprocating handpiece for hand filesusing step back technique has never been compared with NiTi rotaryinstrumentation using crown down technique. Also, to the best of our knowledge,Biolase EpicX, K400 Reciprocation Handpiece, and Pro HS Niti Rotary systemshave not been used in the investigations for the same. Therefore, this clinical study proposes toinvestigate the incidence of post-operative pain following chemo-mechanicalpreparation of single rooted teeth having symptomatic apical periodontitis usingrotary instrumentation with Pro HS file system and engine driven reciprocatinginstrumentation with K-flex files along with laser irradiation (by BiolaseEpicX).