Evaluation of postoperative pain intensity following occlusal reduction in teeth associated with symptomatic irreversible pulpitis and symptomatic apical periodontitis: a randomized clinical study

Aim To assess the effect of occlusal reduction on postoperative pain following two visits root canal treatment in posterior mandibular teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis in a randomized clinical trial. Methodology This trial was conducted in the outpatient clinic of the Endodontic Department of the Faculty of Oral and Dental Medicine, Cairo University in Egypt. Forty-four-patients diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis were randomly assigned into two equal groups. The occlusal surfaces of teeth in the intervention group were reduced; whilst those assigned to the control group were left intact. Canal instrumentation was completed in the first visit using Revo-S rotary nickel-titanium files, and pain intensity was assessed using a visual analogue scale (VAS) at 6, 12, 24 and 48 h. Canal filling was completed 7 days later, and pain intensity was assessed at 6 and 12 h. A placebo was given and analgesics were prescribed to be administered in case of severe postoperative pain. Data were analysed using Independent t-test, chisquare and Fisher Exact tests. Results The mean pain scores within the two groups were associated with a significant continuous decrease over time. Following both instrumentation and canal filling, the mean pain scores in the intervention group were lower than those in the control group at all follow-up periods and this difference was only significant at 12 h (P = 0.021 and P = 0.015, respectively). Conclusions Occlusal reduction reduced levels of postoperative pain in posterior mandibular teeth with symptomatic pulpitis and apical periodontitis only 12 h following both canal preparation and root filling.