Effect of Reciprocating versus Rotary Instrumentation on Post-endodontic Pain and Endotoxins Level in Infected Root Canals: A Randomised Clinical Trial

Background: This randomised, prospective, controlled trial aimed to assess the effect of reciprocatingsingle-file and rotary instrumentation on the intensity of postoperative pain and the amount of endotoxins inprimarily infected root canals.Methodology: Forty participants were randomly assigned into two equal groups according to root canalinstrumentation technique (n = 20), control group: root canals were instrumented using ProTaper Next rotarysystem and intervention group: canals were instrumented using WaveOne Gold reciprocating instrumentationsystem. Root canal treatment was carried out on two visits and postoperative pain of participants wasmeasured using a numerical rating scale (NRS) at predetermined time intervals 6, 12, 24, 48 hours afterinstrumentation and obturation appointments. Quantification of endotoxins was done using the Sandwich-ELISA method at predetermined time intervals (after access cavity preparation and after completion ofinstrumentation). Pain score data were summarised as mean and standard deviation.Results: No statistically significant difference was noted between the single-file reciprocating system(WaveOne Gold) and the multiple-file rotary system (ProTaper Next) regarding postoperative pain andreduction in the amount of endotoxins (P > 0.05).Conclusion: Both single-file reciprocating instruments and multi-file rotary instruments resulted in mild tomoderate postoperative pain and comparable reduction of endotoxins level.