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Additional root canal enlargement increases immediate postoperative pain: a randomized controlled trial.
Aline Lima Harter1, Fábio de Almeida Gomes2, Samantha Rodrigues Xavier1
1Universidade Federal de Pelotas - UFPel, Postgraduate Program in Dentistry, Dental Clinical Area, RS, Brazil.
Brazilian Oral Research
|October 15, 2025
Summary
Additional enlargement after single-file root canal preparation increases immediate postoperative pain. This effect diminishes within 48 hours, showing no long-term impact on pain or root canal filling extrusion.
Area of Science:
- Endodontics
- Dental Traumatology
Background:
- Single-file instrumentation is a modern endodontic technique.
- Postoperative pain is a common concern after root canal treatment.
Purpose of the Study:
- To evaluate the impact of additional enlargement after single-file instrumentation on postoperative pain.
- To compare pain incidence, intensity, and analgesic use between single-file and additional enlargement techniques.
Main Methods:
- Prospective, double-blind, randomized clinical trial.
- Fifty-six patients with asymptomatic apical periodontitis.
- Assessment of pain using Numerical Pain Assessment Scale (NPAS) at 24 hours, 48 hours, and 7 days.
Main Results:
- Higher incidence and intensity of postoperative pain at 24 hours in the additional enlargement group.
- No significant difference in pain between groups at 48 hours and 7 days.
- Similar incidence of root canal filling extrusion in both groups.
Conclusions:
- Additional enlargement following single-file root canal preparation leads to increased short-term postoperative pain.
- The technique does not significantly affect long-term pain or lead to more extrusion incidents.
