Comparison of postoperative pain following endodontic treatment using rotary file systems with rotational and reciprocating motions: A prospective clinical study

Aim: This study aimed to compare the effects of rotary file systems with different kinematic principles on postoperative pain at various time intervals in single-visit root canal treatment of vital mandibular premolars, and to evaluate their impact on analgesic intake. Materials and Methods: A total of 121 patients aged between 18 and 65 years, who met the inclusion criteria and presented to the Department of Endodontics at the Faculty of Dentistry, Recep Tayyip Erdoğan University, were included in this study. All treatments were performed by a single operator in a single visit. The patients were divided into two groups: Group 1 — T-endo MUST (TeM) (n = 62) and Group 2 — Scope RS Narrow (SRN) (n = 59). Postoperative pain levels were assessed using a visual analog scale on the 1st, 3rd, 5th, and 7th days after the procedure, and analgesic intake was also recorded. Results: A significant reduction in postoperative pain scores was observed over time in both groups (p < 0.001). On the third day, the mean pain scores in the TeM group were statistically significantly higher compared to the SRN group (p = 0.019). Additionally, 12.9% of patients in the TeM group (n = 8) required analgesics, whereas none in the SRN group did, a statistically significant difference (p = 0.004). Conclusion: These findings suggest that the kinematic features of rotary file systems may influence postoperative pain. Compared to the TeM system with reciprocating motion, the SRN system using continuous rotation caused less postoperative pain and did not necessitate analgesic intake in any patient. This can be considered a clinically relevant advantage for patient comfort. These results indicate that the selection of rotary systems should be considered in clinical decision-making to improve patient satisfaction in endodontic treatments. Keywords: Visual analog scale, Root canal treatment, Postoperative pain, Scope RS Narrow, T-endo MUST