The effect of different concentrations and temperatures of sodium hypochlorite irrigation on pain intensity following endodontic treatment of mandibular molars with irreversible pulpitis: A randomized, double-blind clinical trial.

OBJECTIVES

This study aimed to determine the severity of pain after endodontic treatment of mandibular molars with irreversible pulpitis following the use of sodium hypochlorite (NaOCl) at different temperatures and concentrations.

METHODS

In this randomized, controlled clinical trial, 72 patients with mandibular molars with irreversible pulpitis were randomly assigned to six groups. The teeth were anesthetized and the root canals were prepared. During the instrumentation, the root canals were irrigated with NaOCl solution at concentrations of 0.5% and 1% and temperatures of 2.5°C, 22°C, and 40°C, 2.5°C were achieved through cryotherapy. Assessment of pain was conducted before, immediately after, and 3, 24, 48, and 72 h after treatment. After obturation, the patients recorded their pain intensity at different time intervals on the visual analog scale (VAS) and reported the number of analgesics tablets they used. The frequency of analgesics tablets and their effect on pain sensation was recorded in the second part of the form. Repeated measures two-way analysis of variance test was used to compare the trend of pain changes over time between two intervals of time in each group. Friedman's nonparametric test was used to compare the intragroup mean score of pain over time and Kruskal-Wallis for comparing the intergroup mean score.

RESULTS

Changes in VAS pain scores of all the groups were significant over time (p < .001). Pain in all the groups decreased immediately after treatment and increased 3 h after treatment. There were no significant differences in pain ratings and the number of analgesics tablets used in the groups of NaOCl with different concentrations and temperatures over time.

CONCLUSIONS

Within the study's limitations, we concluded that there was no significant difference between concentrations of 0.5%, and 1% and temperatures of 2.5°C, 22°C, and 40°C in pain intensity following endodontic treatment of mandibular molars with irreversible pulpitis.