Effects of sodium hypochlorite concentrations and irrigant activation on postoperative pain after single-visit root canal treatment in asymptomatic molars with chronic apical periodontitis: a randomized clinical trial

Title (English)

Effects of sodium hypochlorite concentrations and irrigant activation on postoperative pain after single-visit root canal treatment in asymptomatic molars with chronic apical periodontitis: a randomized clinical trial

Thong tin bai bao / Article info

• Tac gia / Authors: Ecem Karakoyunlu, Kübra Gürler, Koray Yılmaz
• Tap chi / Journal: BMC Oral Health
• Ngay xuat ban / Published: 2026-08-11
• DOI: 10.1186/s12903-026-09567-x
• Nguon / Source: OpenAlex

Abstract (English)

Abstract Background This randomized, single-blind clinical trial evaluated whether sodium hypochlorite (NaOCl) concentration and irrigant activation influence postoperative pain after single-visit root canal treatment in molars with chronic apical periodontitis. Methods One hundred twenty asymptomatic patients were randomly allocated to six groups ( n = 20) in a 2 × 3 factorial design (NaOCl concentration: 2.5% vs. 5.25% and nonactivation [NA], EDDY [VDW; Munich, Germany], or passive ultrasonic irrigation [PUI]). Postoperative pain was recorded using a 10-cm visual analog scale (VAS) at 6, 12, 24, 48, and 72 h. Repeated VAS measurements were analyzed using a linear mixed-effects model with an autoregressive AR (1) covariance structure, including fixed effects for concentration, activation, time, prespecified interactions, and age as covariates; prespecified simple effects at 6 h were examined with Bonferroni adjustment. Results VAS scores decreased significantly over the course of postoperative assessments in all groups (time effect, P < .001). In the overall model, the activation technique had a significant effect on postoperative pain ( P = .011), whereas the NaOCl concentration did not ( P = .529). Significant concentration × activation ( P = .037) and activation × time ( P < .001) interactions were also observed. At 6 h, the only pairwise difference that remained significant after Bonferroni adjustment was between NA and PUI (mean difference 1.546; P < .001), whereas the comparisons between NA and EDDY and between EDDY and PUI were not statistically significant. Analgesic intake (18.3%) was analyzed as a secondary outcome using patient-level logistic regression. The NaOCl concentration was not associated with analgesic intake ( P = .972). In contrast, compared with those in the PUI group, participants in the EDDY group had significantly greater odds of analgesic intake than those in the PUI group (OR = 4.022; P = .036). Conclusions Overall, under this clinical protocol, the activation modality appeared to have a greater influence on early postoperative pain than the NaOCl concentration alone did. However, postoperative pain scores remained generally low across all groups, suggesting that the clinical significance of these differences should be interpreted with caution. Trial registration Current controlled trials NCT07033247 registered on 13 June 2025. Retrospectively registered.

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Bai dang tu dong boi plugin Ortho OA Fetcher. Anh (neu co) tu PubMed Central. Noi dung lay tu nguon open access va dich tu dong – chi mang tinh tham khao.