scholarly journals Influence of maintaining apical patency in post-endodontic pain

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Snigdha Shubham ◽  
Manisha Nepal ◽  
Ravish Mishra ◽  
Kishor Dutta
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Linear Regression Analysis ◽  
Secondary Outcome ◽  
Preoperative Pain ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Number Of Visits

Abstract Background The concept of instrumentation beyond the apical foramen by small flexible file to prevent apical blockage is apical patency. However, this procedure might endow postoperative pain, thus to maintain apical patency or not is the matter of dilemma. Hence, the primary objective of this study was to compare postoperative pain between apical patency and non-patency groups and secondary objective was to evaluate the influence of number of visits, vitality of teeth, group of teeth and preoperative pain on post-operative pain. Methods Preselected (n = 178) patients based on group of teeth and status of pulp were randomly divided into 2 groups, apical patency and non-patency which was further treated in either single or multiple visits. After exclusion, 160 patients were included. Each group (n = 80) was subdivided in single visit (n = 40) and multiple visits (n = 40), including vital (n = 20) and non-vital teeth (n = 20) and single-rooted (n = 10) and multiple-rooted teeth (n = 10). Apical patency was maintained with a size 10 K-file during conventional hand filing step-back shaping procedure. Intensity of pain was recorded before treatment and on days 1, 2, and 7 after treatment using Numerical Rating Scale (NRS-11). Statistical analysis was done using Mann–Whitney U test, Spearman correlation and Multiple linear regression analysis. Results The primary outcome of this study showed statistically significant difference (p < 0.05) in postoperative pain scores between patency and non-patency groups with higher pain scores in patency group on 1st, 2nd and 7th day follow up. The secondary outcome showed postoperative pain in patency-maintained group was influenced by status of the pulp and preoperative pain only. Vital teeth of patency-maintained group treated in multiple visits showed statistically significant (p = 0.02) post-operative pain in day 1 follow up. Pre-operative pain showed positive correlation with postoperative pain with statistically significant difference. Conclusions Our study concluded that maintenance of apical patency increased postoperative pain. Evaluation of influence of number of visits, status of pulp, group of tooth and preoperative pain revealed status of pulp and preoperative pain as influencing factors for postoperative pain in patency group.

scholarly journals Influence of maintaining apical patency in post-endodontic pain

2020 ◽  
Author(s):  
Snigdha Shubham ◽  
Manisha Nepal ◽  
Ravish Mishra ◽  
Kishor Dutta
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Linear Regression Analysis ◽  
Secondary Outcome ◽  
Preoperative Pain ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Number Of Visits

Abstract Background The concept of instrumentation beyond the apical foramen by small flexible file to prevent apical blockage is apical patency. However, this procedure might endow postoperative pain, thus to maintain apical patency or not is the matter of dilemma. Hence, the primary objective of this study was to compare postoperative pain between apical patency and non-patency groups and secondary objective was to evaluate the influence of number of visits, vitality of teeth, group of teeth and preoperative pain on post-operative pain.Methods Preselected (n=178) patients based on group of teeth and status of pulp were randomly divided into 2 groups, apical patency and non- patency which was further treated in either single or multiple visit. After exclusion, 160 patients were included. Each group (n=80) was subdivided in single visit (n = 40) and multiple visits (n = 40), including vital (n=20) and non-vital teeth (n=20) and single- rooted (n=10) and multiple-rooted teeth (n=10). Apical patency was maintained with a size 10 K-file during conventional hand filing step-back shaping procedure. Intensity of pain was recorded before treatment and on days 1, 2, and 7 after treatment using Numerical Rating Scale (NRS-11). Statistical analysis was done using Mann -Whitney U test, Spearman correlation and Multiple linear regression analysis.Results The primary outcome of this study showed statistically significant difference (p<0.05) in postoperative pain scores between patency and non-patency groups with higher pain scores in patency group on 1st, 2nd and 7th day follow up. The secondary outcome showed postoperative pain in patency maintained group was influenced by status of the pulp and preoperative pain only. Vital teeth of patency-maintained group treated in multiple visits showed statistically significant (p=0.02) post-operative pain in day 1 follow up. Pre-operative pain showed positive correlation with postoperative pain with statistically significant difference.Conclusions Our study concluded that maintenance of apical patency increased postoperative pain. Evaluation of influence of number of visits, status of pulp, group of tooth and preoperative pain revealed status of pulp and preoperative pain as influencing factors for postoperative pain in patency group.

scholarly journals Influence of maintaining apical patency in post-endodontic pain

2020 ◽  
Author(s):  
Snigdha Shubham ◽  
Manisha Nepal ◽  
Ravish Mishra ◽  
Kishor Dutta
Keyword(s):  
Postoperative Pain ◽  
Linear Regression Analysis ◽  
Secondary Outcome ◽  
Preoperative Pain ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Number Of Patients ◽  
Significant Difference ◽  
Number Of Visits

Abstract BackgroundThe concept of instrumentation beyond the apical foramen by small flexible file to prevent apical blockage is apical patency. However, this procedure might endow postoperative pain, thus to maintain apical patency or not is the matter of dilemma. Hence, the primary objective of this study was to compare postoperative pain between apical patency and non-patency groups and secondary objective was to evaluate the influence of number of visits, vitality of teeth, group of teeth and preoperative pain on post-operative pain.MethodsOne hundred sixty patients were included in the study. Patients were randomly divided into: Group A (n = 80) contained apical patency maintained and Group B (n = 80) contained those treated without apical patency. Each group was subdivided into equal number of patients treated in single visit (n = 40) and multiple visits (n = 40), including vital (n=20) and non-vital teeth (n=20) and single- rooted (n=10) and multiple-rooted teeth (n=10). Apical patency was maintained with a size 10 K-file during conventional hand filing step-back shaping procedure. Intensity of pain was recorded before treatment and on days 1, 2, and 7 after treatment using a Numerical Rating Scale (NRS-11). Statistical analysis was done using Mann -Whitney U test, Spearman correlation and Multiple linear regression analysis.ResultsThe primary outcome of this study showed statistically significant difference (p<0.05) in postoperative pain scores between patency and non-patency groups with higher pain scores in patency group on 1st, 2nd and 7th day follow up. The secondary outcome showed postoperative pain in patency maintained group was influenced by status of the pulp and preoperative pain only. Vital teeth of patency-maintained group treated in multiple visits showed statistically significant (p=0.02) post-operative pain in day 1 follow up. Pre-operative pain showed positive correlation with postoperative pain with statistically significant difference.ConclusionsOur study concluded that maintenance of apical patency increased postoperative pain. Evaluation of influence of number of visits, status of pulp, group of tooth and preoperative pain revealed status of pulp and preoperative pain as influencing factors for postoperative pain in patency group.

scholarly journals Influence of maintaining apical patency in post-endodontic pain

2020 ◽  
Author(s):  
Snigdha Shubham ◽  
Manisha Nepal ◽  
Ravish Mishra ◽  
Kishor Dutta
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Preoperative Pain ◽  
Post Operative Pain ◽  
Number Of Patients ◽  
Significant Difference ◽  
Number Of Visits ◽  
Group B

Abstract Background The purpose of this study was to compare postoperative pain between apical patency and non-patency groups and to evaluate the influence of number of visits, vitality of teeth, group of teeth and preoperative pain on post-operative pain. Methods One hundred sixty patients were included in the study. Patients were randomly divided into: Group A (n = 80) contained apical patency maintaining group and Group B (n = 80) contained those treated without maintaining apical patency. Each group was subdivided into equal number of patients treated in single visit (n = 40) and multiple visits (n = 40), including vital (n = 20) and non-vital teeth (n = 20) and single- rooted teeth (n = 10) and multiple-rooted teeth (n = 10). Apical patency was maintained with a size 10 K-file during conventional hand filing step-back shaping procedure. Intensity of pain was recorded before treatment and on days 1, 2, and 7 after treatment using a numerical rating scale. Statistical analysis was done using Mann -Whitney U test and Spearman correlation. Results There was statistically significant difference (p < 0.05) in postoperative pain scores between the groups on 1st, 2nd and 7th day follow up. Postoperative pain in patency maintaining group was not influenced by number of visit and group of teeth treated. Whereas, vital teeth when patency was maintained in multiple visits root canal treatment post-operative pain was statistically significant (p = 0.02) in day 1 follow up. Pre-operative pain also influenced postoperative pain with statistically significant difference and positive correlation between the groups. Conclusions Our study concluded that maintenance of apical patency increased postoperative pain. Post-operative pain was not influenced by number of visits, and group of teeth. However, for patency group, vital tooth treated in multiple visits results in more postoperative in 1st day follow up. In addition, pre-operative pain also has influence on post-operative pain.

Medicaid Payer Status Is a Predictor of Early Postoperative Pain Following Upper Extremity Procedures

Hand ◽  
2020 ◽  
pp. 155894472091256
Author(s):  
Michael T. Scott ◽  
Allison L. Boden ◽  
Stephanie A. Boden ◽  
Lauren M. Boden ◽  
Kevin X. Farley ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Upper Extremity ◽  
Private Insurance ◽  
Insurance Status ◽  
Preoperative Pain ◽  
Pain Scores ◽  
Patient Reported ◽  
Before And After ◽  
Subjective Pain

Background: The purpose of this study was to investigate the relationship between insurance status and patient-reported pain both before and after upper extremity surgical procedures. We hypothesized that patients with Medicaid payer status would report higher levels of pre- and postoperative pain and report less postoperative pain relief. Methods: In all, 376 patients who underwent upper extremity procedures by a single surgeon at an academic ambulatory surgery center were identified. Patient information, including insurance status and Visual Analog Scale pain score (VAS-pain) at baseline, 2 weeks, and 1, 3, and 6 months, were collected. VAS-pain scores were compared with t-tests and linear regression. Results: Preoperatively and at 2-week, 1-month, and 3-month follow-up, Medicaid patients reported statistically significant higher pain levels than patients with Private insurance, finding a mean adjusted increase of 0.51 preoperatively, 0.39 at 1 month, and 0.79 at 3 months. Preoperatively and at 3-month follow-up, Medicaid patients reported statistically significant higher pain than patients with Medicare, finding increases in VAS-pain of 0.99 preoperatively and 0.94 at 3 months. There was no difference in pain improvement between any insurance types at any time point (all P values > .05). Conclusions: Patients with Medicaid report higher levels of preoperative pain and early postoperative pain, but reported the same improvement in pain as patients with other types of insurance. As healthcare systems are becoming increasingly dependent on patient-reported outcomes, including pain, it is important to consider that differences may exist in subjective pain depending on insurance status.

Clinical trial to assess role of ketamine in post operative analgesia after laparoscopic cholecystectomy

2021 ◽  
Vol 23 (05) ◽  
pp. 421-432
Author(s):  
Dr. Mohammad Kheiri Mahmod ◽  
◽  
Dr. Bashar Naser Hussein ◽  
Dr. Ammar Hamid Hanoosh ◽  
◽  
...  
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Analgesic Requirement ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.

scholarly journals Intra-canal medication containing silver nanoparticle versus calcium hydroxide in reducing postoperative pain: A randomized clinical trial

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1949
Author(s):  
Fatma El Zahraa El Abbasy ◽  
Salsabyl Ibrahim ◽  
Olfat Shaker ◽  
Geraldine Ahmed
Keyword(s):  
Silver Nanoparticles ◽  
Postoperative Pain ◽  
Calcium Hydroxide ◽  
Root Canal ◽  
Rating Scale ◽  
Treatment Success ◽  
Pain Scores ◽  
Mechanical Preparation ◽  
Significant Difference ◽  
Micro Organisms

Background: Pain of endodontic origin can be annoying for patients and endodontist. Pain relief is more important to the patient than treatment success. Numerous factors such as over instrumentation, over filling, debris extrusion can cause postoperative pain. However, bacteria found in the root canal space is the most important factor. Therefore mechanical preparation is an important step in elimination of micro-organisms from the root canal. It has been reported that micro-organisms can still survive inside the root canal even after mechanical preparation. Hence, the use of intra-canal medicaments in between visits for reduction of bacteria inside the root canal space has been recommended. The aim of this study was to assess the ability of silver nanoparticles versus calcium hydroxide used as intra-canal medication in reducing pain in necrotic teeth with apical periodontitis. Methods: Thirty-four participants were randomly divided into 2 groups, 17 in each group according to intra-canal medication used silver nanoparticles and calcium hydroxide (AgNPs and Ca(OH)2). Each patient was given pain scale chart numerical rating scale (NRS) in order to record his/her pain level before any intervention followed by placement of intra-canal medicament for 1 week. Postoperative pain was recorded at 4, 12, 24, 48 hours. Results: Pre-operatively; there was no statistically significant difference between mean pain scores in the two groups. After 4, 12 as well as 24 hours, Ca(OH)2 group showed statistically significantly higher mean pain score than AgNPs group. After 48 hours; there was no statistically significant difference between mean pain scores in the two groups. Conclusions: There was a statistically significant difference in postoperative pain following 4, 12, and 24 hours where AgNPs group resulted in reduction of pain more than Ca(OH)2 group. At 48 hours, there was no statistically significant difference. Trial registration: PACTR PACTR201602001444180 26/01/2016

scholarly journals Comparison of Postoperative Pain between Patients who underwent Primary and Repeated Caesarean Section: A Prospective Cohort Study

2019 ◽  
Author(s):  
Guangyou Duan ◽  
Guiying Yang ◽  
Jing Peng ◽  
Zhenxin Duan ◽  
Jie Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Cesarean Section ◽  
Visceral Pain ◽  
Postoperative Patient ◽  
Cesarean Deliveries ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Intravenous Analgesia

Abstract Background: The presences of differences in post-operative pain are unclear between the primipara who underwent a primary cesarean section and multipara who underwent first repeat cesarean section. The study aimed to explore the possible difference in postoperative pain between primipara and multipara. Methods: Women who underwent cesarean deliveries under spinal anesthesia were included, and postoperative patient-controlled intravenous analgesia was performed. Postoperative incision and visceral pain within 48 hours after the surgery were evaluated. Serum leukocyte and neutrophil counts before and 24 hours after the surgery were retrospective collected. Additionally, the patients’ pain statuses on postoperative week 1 and week 4 were also assessed during follow-up via telephone. Results: A total of 168 patients (67 primipara and 101 multipara) were included. The multipara showed less risk for experiencing moderate to severe incision pain during the 48 hours after the surgery than the primipara (15.8%vs.37.3%; P=0.001). In patients under 30 years old, inadequate treatment of the visceral pain in the multipara was higher than that of the primipara (22.7%vs.6.4%; P=0.026). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multipara and primipara (33.7%vs.40.2%, P=0.381). Additionally, a significantly higher incidence of pain at 4 weeks after the surgery was noted in the primipara compared to the multipara (55.4%vs.36.1%, P=0.015). Conclusions: Individual differences between the primipara and multipara should be considered in the management of postoperative analgesia for those who have undergone Cesarean deliveries.

scholarly journals Endoscope-Assisted Minimally Invasive Interlaminar Lumbar Decompression for Spinal Stenosis

2019 ◽  
Vol 6 (22;6) ◽  
pp. E573-E578
Author(s):  
Chan Hong Park
Keyword(s):  
Rating Scale ◽  
Numeric Rating Scale ◽  
Secondary Outcome ◽  
Lumbar Stenosis ◽  
Lumbar Decompression ◽  
Pain Scores ◽  
Number Of Patients ◽  
Study Setting ◽  
Numeric Rating

Background: Lumbar stenosis is characterized by a narrowing of the spinal canal in association with progressive degenerative changes in the lumbar spine and surrounding structures, including hypertrophy of the ligamentum flavum (LF). Objectives: The aim of this study was to examine the usefulness of endoscope-assisted interlaminar lumbar decompression (EILD) for patients with lumbar stenosis and hypertrophy of the LF. Study Design: Retrospective study. Setting: Department of Anesthesiology and Pain Medicine, Neurosurgery at Wooridul Spine Hospital. Methods: A total of 51 patients were enrolled in this study. Outcomes were evaluated at baseline and at 2 weeks and 6 months postprocedure via the Numeric Rating Scale, Oswestry Disability Index (ODI), and Zurich Claudication Questionnaire (ZCQ). Results: Mean posttreatment pain scores at 2 weeks and 6 months were significantly lower, and ODI scores were significantly decreased compared with baseline. ZCQ scores were also significantly decreased compared with pretreatment surveys. Two patients required reoperation within one month. At postprocedure 6 months, a ≥ 50% reduction in pain score was recorded in 26 (80%) of 51 patients, and there was ≥ 40% reduction in ODI score in 82% of patients. No serious complications including epidural bleeding, dural or neural injuries, or infection were recorded. Limitations: This study lacked secondary outcome substantiation. In addition, the follow-up period was short (< 6 months), and no patients had postprocedure magnetic resonance imaging. The number of patients was also small. Conclusions: EILD provided good outcomes and may be a reasonable treatment option for carefully selected patients with hypertrophy of the LF.

scholarly journals Comparison of the Efficacy and Tolerability of Dienogest and Dienogest Plus Ethinylestradiol on Endometriosis Related-Pain

2019 ◽  
pp. 1
Author(s):  
Tolga Karacan ◽  
Huseyin Kiyak ◽  
Eser Ozyurek ◽  
Mevlide San ◽  
Engin Oral
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Similar Efficacy ◽  
Reproductive Age ◽  
Pain Scores ◽  
Significant Difference ◽  
Pain Symptoms

<p><strong>Objective:</strong> Endometriosis is a common gynecological condition that affects many women of reproductive age worldwide and is a major cause of pain and infertility. Treatment of endometriosis can be either surgical, aiming to restore normal anatomy by removing endometriotic lesions, or hormonal. Various medical treatments with different doses, formulations, delivery systems, and regimens have been tested. The main objective of this study was to compare the efficacy and tolerability of dienogest and dienogest plus ethinylestradiol on endometriosis-related pain. Additionally, the effects on endometrioma size were examined.</p><p><strong>Study Design:</strong> A total of 81 patients with clinically diagnosed endometrioma, who had chronic pelvic pain, dysmenorrhea, or deep dyspareunia between January 2015 and December 2018 were studied retrospectively. The patients were divided into two main groups: continuous oral dienogest (n=43) (Visanne®, 2 mg/day) and continuous oral dienogest plus ethinylestradiol (n=38) (Dienille®, 2 mg/0.03 mg/day). The intensity of pain symptoms was evaluated before therapy, then after 3 and 6 months of treatment using a 10-point numerical rating scale (0 = no pain and 10 = worst possible pain) (NRS) provided to the patients in advance.</p><p><strong>Results:</strong> The pain scores related to chronic pelvic pain decreased 36% for dienogest and 49% for dienogest plus ethinylestradiol (p&lt;0.05) and scores for dysmenorrhea decreased 38% and 44% respectively (p&lt;0.05) at 6 months, significantly lower than before treatment. At the 6-month follow-up, a 28% decrease in the pain scores related to deep dyspareunia in the dienogest group was statistically significant. Although the dienogest plus ethinylestradiol group also decreased by 20%, the difference was not significant. There was no significant difference in endometrioma size between the two groups at the 6-month follow-up (dienogest and dienogest plus ethinylestradiol; 24.2±17.5 mm vs. 27.5±19.1 mm, respectively; p=0.42).</p><p><strong>Conclusion:</strong> Upon analysis of our 6 months of clinical data, estrogen-progestin and a progestin alone seem to be of similar efficacy for the temporary treatment of endometriosis-related pain. The dienogest plus ethinylestradiol combination was slightly less effective on deep dyspareunia but was still well tolerated. Similarly, the two hormonal regimens posed no superiority over one another with regard to endometrioma size reduction.</p>

scholarly journals Evaluation of postoperative pain in infected root canals after using double antibiotic paste versus calcium hydroxide as intra-canal medication: A randomized controlled trial

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1768 ◽  
Author(s):  
Sarah Samir Abouelenien ◽  
Salsaby Mohamed Ibrahim ◽  
Olfat Gamil Shaker ◽  
Geraldine Mohamed Ahmed
Keyword(s):  
Postoperative Pain ◽  
Calcium Hydroxide ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Apical Periodontitis ◽  
Preoperative Pain ◽  
Root Canals ◽  
Significant Difference ◽  
Double Antibiotic Paste

Background: Postoperative pain is defined as pain of any degree after initiation of endodontic treatment either intra-appointment or post-obturation and is considered an undesirable occurrence for both patient and dentist. It was suggested that bacterial injury is probably the major cause of pain. Intra-canal medicaments are widely used to kill any bacteria surviving after instrumentation and irrigation. The aim of this study was to assess the ability of double antibiotic paste versus calcium hydroxide used as intra-canal medication in reducing postoperative pain. Methods: 36 patients with single rooted necrotic premolars with apical periodontitis were randomly assigned into two groups according to the intra-canal medication used: calcium hydroxide group (CH) and double antibiotic paste group (DAP). Preoperative pain was recorded using numerical rating scale. After isolation, access cavity was performed followed by chemico-mechanical preparation using rotary Race files with 2.5% sodium hypochlorite irrigation. Subsequently, intra-canal medication was placed and postoperative pain was recorded at 6, 12, 24 and 48 hours postoperatively. Results: There was no statistically significant difference between both groups. Both groups resulted in an increase in median pain value from preoperative to 6 hours postoperative, followed by gradual decrease from 6 hours to 12, 24, 48 hours postoperatively with statistically significant difference. When comparing both groups, DAP group showed lower postoperative pain values than CH group at 12 and 24 hours, but this was not statistically significant. Conclusion: The use of intra-canal medication in necrotic teeth with apical periodontitis was efficient in reducing postoperative pain regardless of type of intra-canal medication used. Trial registration: PACTR201605001482394 (Date: 22nd February 2016).

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