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POSTOPERATIVE

QUALITY OF LIFE
FOLLOWING SINGLEVISIT
ROOT CANAL TREATMENT
PERFORMED BY
PROTAPER NEXT,
ONESHAPE AND
WAVEONE GOLD FILES

INTRODUCTION

AIM
To compare the impact of instrumentation with protaper
next, oneshape and waveone gold files on postoperative
quality of life (POQoL) after single-visit root canal
treatment.

METHODOLOGY
Eligibility criteria:
Symptomatic irreversible pulpitis with or without
symptomatic apical periodontitis
Asymptomatic patients, sinus tract, periapical abscess or
facial cellulitis
Patients with physical or psychological disabilities or
inability to understand study instructions were excluded.
Informed written consent

Group
1
Group
2
Group
3

Protaper next
n = 20
Oneshape
n = 20
Waveone gold
n = 20

INTERVENTIONS
Medical and dental status and history
Intra-oral examinations
Pulpal and periradicular status were assessed with
thermal and electric pulp tests
Periapical radiographic examination

POQoL was evaluated with an ad hoc prepared


questionnaire
Difficulty in chewing, speaking, sleeping, carrying out
daily functions, social relations
Likert scale ranging from 0 (none) to 10 (very much).
Postoperative pain - visual analogue scale (VAS)
Analgesic intake
Days to complete pain resolution after treatment.

STATISTICAL ANALYSIS
Oneway anova
Chisquare tests
Posthoc tests

RESULTS
60 patients, 34 males, 26 females.
35%, 15 30 years, 40%, 31-45 years, 25%, 46-60 years.
Pre-operative
variables
Premolars
Molars
Symptomatic
irreversible
pulpitis
Symptomatic
apical
periodontitis
Pre-op mean pain
score
Pre-op quality of
life scores

Group 1
(Protaper
next)
6
14
15

Group 2
(onesha
pe)
5
15
16

Group 3
(waveone
gold)
6
14
14

6.20
1.79
2.61 0.97

6.10
1.59
2.79 0.82

5.80
1.58
2.90 0.74

0.921;
NS
0.766;
NS

0.891N
S
0.755
NS

Day

Group 1

Group 2

Pre-op

6.20
1.79
Day 1
2.55
1.15
Day 2
1.25
0.91
Day 3
0.55
0.83
Day 4
0.25
Mean Pain Score
(VAS)
0.55
*p<0.05;
Day
5 Significant
0.20
0.52
Day 6
0.05
0.22
Day 7
0.05
0.22
7.00
6.00 6.20

6.10

2.80
1.60
1.05
0.65
0.20
0.05
0.05

Group
2 vs 3
0.849

0.639

0.939

0.042*

0.295

0.026*

0.519

0.030*

0.506

0.439

0.120

0.120

0.120

0.531

0.531

2.95
2.15

2.80
2.55

1.00
0.00
Pre-op

5.80
1.58
1.15
2.95
0.839
1.64
1.23
2.15
0.606
1.14
0.95
1.40
0.267
1.10
0.81
0.95
0.302
0.99
0.52
0.45
1.000
0.76
Mean
Pain
0.22
0.30
1.000
0.57
Group 1
Group
2
Group 3
0.22
0.15
1.000
0.37

Group
1 vs 3
0.748

5.80

4.00
2.00

Group
1 vs 2
0.982

6.10 1.59

5.00
3.00

Group 3

1.60

1.05

1.25
0.55
Day 1

Day 2

1.40

Day 3

0.65

0.25
Day 4

0.95

0.45
0.20

0.20
Day 5

0.30
0.05

Group 3
0.15
Group 2
0.05

0.05
Group 1
0.05
Day 6 Day 7

Day

Group 1

Group 2

Pre-op

2.61
0.97
Day 1
1.19
0.60
Day 2
0.70
0.45
Day 3
0.26
0.39
Day 4
0.11
0.27
Mean PQOL
5
0.08
*p<0.05;Day
Significant
0.24
Day 6
0.04
0.19
Day 7
0.41
0.27

Group 3

Group
1 vs 2
0.788

2.79 0.82

2.90
0.74
1.61 0.68
1.91
0.163
0.77
0.90 0.51
1.15
0.485
0.59
0.54 0.46
0.74
0.165
0.51
0.30 0.35
0.41
0.257
0.45
0.11 0.19
0.21
0.946
0.36
0.06 0.15
0.14
0.979
0.29
Mean PQOL
Score
0.45 0.22
0.50
0.897
Group 1
Group 2
Group 3
0.33

Group
1 vs 3
0.555

Group
2 vs 3
0.924

0.007*

0.394

0.031*

0.326

0.008*

0.416

0.036*

0.616

0.333

0.512

0.418

0.534

0.581

0.846

2.90
3.00

2.79

2.50 2.61

1.91

2.00

1.61

1.15

1.50
1.00
0.50
0.00
Pre-op

0.54

0.70

Day 2

0.41
0.30

0.26
Day 1

0.74

0.90

1.19

Day 3

0.11
Day 4

0.21
0.11

0.08
Day 5

0.14
0.06

0.50
0.45 Group 3

Group 2
0.41
Group 1

0.04
Day 6 Day 7

Mean Number of
Tablets taken
The day medication
was stopped

Group 1
(Protaper
next)
3.10
3.16

Group 2
(oneshape)
4.50 3.17

Group 3
(waveone
gold)
4.60
3.78

P
0.300; NS

2.10 1.41

2.50 1.50

2.65 1.57

0.489; NS

DISCUSSION
Host factors, idiopathic factors and aspects related to
chemomechanical root canal debridement
Preoperative pain prevalence, periapical radiolucency
Tooth type and patients age, gender.

Reciprocating motion - relieves cyclic fatigue stress, while


preserving the original canal anatomy
Greater extent of debris extrusion using the reciprocating
Single-file system compared with full-sequence rotary niti
instruments
Instrument design has a greater impact than the number of
instruments on neuropeptide expression in the periodontal
ligament
One shape files have been shown to bring about significantly
higher canal straightening and apical transportation

Wang et al., single or multiple visits- no significant


differences were observed between groups
Figini et al., systematic review reported a slightly higher
frequency of pain and analgesic use in patients who had
undergone single-visit treatment
Significantly higher pain experience and analgesics
consumption in patients treated with reciprocating
instruments were found

CONCLUSION
The incidence of postoperative pain was similar in
protaper next and oneshape
Reciprocation motion had an impact on immediate
postoperative discomfort, when performed in a single
visit
No difference in medication taken

REFERENCES
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randomized multicenter clinical study, Clin Oral Investig.2015
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instrumentation: a randomized clinical trial. Int Endod J.2015
Oct 15.
Comparison of the effect of root canal preparation by using
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clinical trial. Journal of Endodontics 41, 5758.

Incidence of postoperative pain after intracanal procedures


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Apically extruded debris with reciprocating single-file and full-sequence


rotary instrumentation systems. Journal of Endodontics 38, 8502.
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ACKNOWLEDGEMENTS
Dr. Chandrasekhar (prof & HOD)
Dr. Vijetha (prof)
Dr. Muralidhar (reader)
Dr. Harikiran (reader)
Dr. Vaibhav jain (sr lecturer)
Dr. Sai Krishna (sr lecturer)