Farklı kök kanal dezenfeksiyon prosedürlerinin postoperatif ağrı üzerine etkisinin değerlendirilmesi

---

Thesis Type: Dental Specialty

Institution Of The Thesis: Sivas Cumhuriyet University, Diş Hekimliği Fakültesi, Klinik Bilimler Bölümü, Turkey

Approval Date: 2025

Thesis Language: Turkish

Student: İBRAHİM AKDENİZ

Supervisor: Demet Altunbaş

Open Archive Collection: AVESIS Open Access Collection

Abstract:

The effects of root canal disinfection procedures performed with conventional needle irrigation, sonic activation, passive ultrasonic activation, and KTP laser on postoperative pain were investigated in this study. A total of 80 patients with asymptomatic devital single root and single canal mandibular premolar teeth participated in the study. The patients were randomly divided into four groups, and each group received a different final irrigation and disinfection procedure: conventional needle irrigation (CNI), sonic irrigation (SI), passive ultrasonic irrigation (PUI), and KTP laser disinfection. Mandibular anesthesia was administered, and access cavity was prepared in tooth isolated with a rubber dam. The working length was determined and root canal preparation was performed using the One Curve rotary file system. During preparation, irrigation was performed with a total of 6 ml of 2.5% NaOCl solution using a 31G side-vented irrigation needle at a rate of 2 ml/20 sec. Following this, the final irrigation procedure was performed according to the pre-determined activation and disinfection groups. Final irrigation consisted of three irrigation cycles, each applied for 20-sec, with a total of 6 ml of 2.5% NaOCl solution. After each irrigation cycle, a 20-sec resting time was applied in the CNI and KTP laser groups and a 20-sec activation was performed in the SI and PUI groups. Subsequently, irrigation was performed with 2 ml of 17% EDTA for 1 minute, followed by a 1-minute resting/activation. 2 ml of distilled water was used as the final irrigation solution. In the KTP laser group, KTP laser was applied to the root canal dried with sterile paper points. The root canal was filled using the single-cone technique with gutta-percha and AH Plus sealer. Permanent resin composite restoration of the tooth was performed in the same session. To evaluate pain, patient was given a postoperative pain assessment form and were asked to mark the intensity of the pain at 6, 24, 48 and 72 hours, and on the 7th day on a VAS. A clinical follow-up and percussion evaluation were performed on the 7th day. The data were statistically analyzed using Shapiro-Wilk, variance analysis, Tukey test, Bonferroni, Kruskal-Wallis test, Mann-Whitney U test, Friedman test, Wilcoxon test, and Chi-square tests, and the significance level was defined as p 0,05). In all groups, the highest postoperative pain scores were recorded at 6 hours. While age and gender did not significantly affect postoperative pain levels, patients with periapical lesions reported significantly less postoperative pain in the CNI group at the 6th hour, in the SI group at the 48th hour, and at the 48th hour when all patients were evaluated (p<0.05). Within the limitations of this study, root canal disinfection procedures performed did not show significant differences in postoperative pain.