Effect of sonic activation using EDDY device on root canal microbiota and postoperative pain in teeth with asymptomatic apical periodontitis: A prospective randomized controlled clinical trial

This study aimed to evaluate the sonic activation device EDDY's effect on root canal microbiota and postoperative pain by comparing traditional side vented needle irrigation. For this purpose samples collected from root canals went under real-time PCR study using primers of Bacteriodes and Firmicutes bacteria groups and searched for a change in samples microbial load. Patients are given Numeric Analog Scale to evaluate postoperative pain. Patients who are systemically healthy, older than 18, and haven't gone any antibiotic or NSAID treatment lately referred to Bezmialem Vakıf University Dentistry Clinic for endodontic treatment were invited to participate in this study. Only the tooth with one root and one canal that show signs of asymptomatic apical periodontitis are included. Patients were separated into 2 groups randomly and during the endodontic treatment irrigation phase, EDDY activation was used on one group while side-vented traditional needle irrigation was used on the other. Both patients' teeth were isolated using a rubber dam and a sample was taken with a cotton pellet for sterilization check after disinfection protocol. It was decided that if there was a presence of bacteria in this sample, the tooth is going to be excluded from the study. Before and after shaping and irrigation protocols samples were taken from the root canal of each tooth. After the first session patients are given a numeric analog scale and questioned about the pain sensation. In the second session, scales were gathered and treatments were completed. Root canal samples were analyzed with the real-time PCR method. T-test and Mann-Whitney U were used for laboratory statistics and the Friedman test was used for postoperative pain evaluation. When the data were evaluated EDDY showed significantly higher bacterial elimination comparing traditional needle irrigation. It was revealed that the EDDY group showed greater bacterial elimination both in Bacteroides (p=0.023) and Firmicutes (0,002) studies. On the postoperative pain evaluation, it was shown that only after 1 hour of treatment there was a significant difference in the EDDY group which showed greater pain (p=0,010). From 2 hours to 1 week there was not any significant difference among the groups (p>0,05). In this study, it was revealed that the EDDY device causes significantly more bacterial elimination compared with traditional needle irrigation. Even if it causes more pain after 1 hour of treatment, there was no significant difference in pain after 2 hours, 1 day, 2 days, and 1 week compared with traditional irrigation. There is a need for more clinical trials using EDDY device.