The effect of di̇fferent irri̇gati̇on acti̇vati̇on methods preferred duri̇ng root canal treatment on postoperati̇ve pai̇n: a randomi̇zed cli̇ni̇cal tri̇al

Aim: The aim of this study is to evaluate the effects of EDDY and passive ultrasonic irrigation activation methods on postoperative pain in mandibular premolar and first molar teeth with asymptomatic apical periodontitis. Material and Methods: This study was designed as a randomized clinical trial. This study was conducted to the Department of Endodontics at Ordu University Faculty of Dentistry between 12.02.2024 and 03.06.2024, involving volunteer patients who met the predetermined inclusion criteria. The activation method to be used was determined by asking patients to choose one of the black envelopes in a box. The root canal treatments of the participants were completed by a single operator (M.S.). A total of 57 patients were assessed for the study, and 48 patients who met the inclusion criteria were included. Follow-up was completed for 45 patients with available postoperative pain data (15 in the control group, 14 in the EDDY group, and 16 in the PUI group). Postoperative pain levels of treated patients were recorded at the 8th hour, 12th hour, 24th hour, 48th hour, and 7th day using visual analog scale measurements. For statistical analysis, the Kruskal-Wallis and Friedman tests were used to evaluate pain scores, and the Chi-square test was applied to assess findings related to gender. Results: In intra-group analyses, gender was found to have no statistically significant effect on the presence of pain (p>0.05). When comparing intergroup measurements of postoperative pain, no statistically significant differences were observed (8th hour: p=.479, 12th hour: p=.577, 24th hour: p=.881, 48th hour: p=.778, 7th day: p=.830). It was noted that the PUI group experienced more pain at the 8th and 12th hours, while the EDDY group reported more pain at the 24th and 48th hours, however, no statistically significant difference was found. Intra-group comparisons revealed a statistically significant reduction in pain levels by the 7th day in both the control and PUI groups, whereas the EDDY group did not show a statistically significant result (Control; p=.007, PUI; p=<.001, EDDY; p=.050). Conclusions: Within the limitations of the data obtained from this study, EDDY and PUI have similar effects on postoperative pain, making them both viable options for irrigation activation. Gender does not have an influence on postoperative pain.