The Effect of Foraminal Enlargement of Necrotic Teeth with the Reciproc System on Postoperative Pain: A Prospective and Randomized Clinical Trial.

Introduction: The aim of this prospective study was to evaluate the postoperative pain that followed root canal treatments performed with a single-file reciprocating system on asymptomatic uniradicular necrotic teeth with and without foraminal enlargements (FEs).

Methods: Forty-six volunteers were randomly divided into 2 groups according to the established working lengths. The FE group had a working length of 0.0 mm from the apex, and the control group had a working length of 1.0 mm short of the apex. The treatments of both groups were performed with a Reciproc R40 (VDW, Munich, Germany) instrument. Both groups underwent the same treatment protocol with the exception of the established working length. The volunteers were instructed to record their pain (none, mild, moderate, or severe) on a visual analog scale at 24 hours, 72 hours, and 1 week after the procedures. The Kruskal-Wallis test was used to identify significant differences.

Results: Overall, 82.22% of the patients indicated no pain or mild pain. A greater proportion of the patients in the FE group reported mild pain compared with patients in the control group in the first 24 hours (P < .05). At 72 hours and 1 week, there were no statistically significant differences between the groups (P > .05).

Conclusions: FEs during endodontic treatments of asymptomatic necrotic, uniradicular teeth that were performed in single visits using the Reciproc R40 reciprocating file resulted in a low incidence of pain. After 24 hours, the FEs resulted in more patients reporting mild pain compared with the control group, but no differences were observed at 72 hours or 1 week.