Radwa Sameeh Emara, Hend Abou El Nasr And Randa Elboghdadi,

ABSTRACT
Objective: The Purpose Of This Randomized Clinical Study Was To Evaluate The Impact Of Occlusal Reduction On The Incidences Of Post-instrumentation And Post-obturation Pain. Subjects And Methods: Forty Four Patients Were Included In This Study. Inclusion Criteria Were Posterior Mandibular Teeth Having Symptomatic Irreversible Pulpitis And Symptomatic Apical Periodontitis. Patients Were Randomized Into Two Equal Groups. In The Intervention Group The Functional And Nonfunctional Cusps Were Reduced Until Absence Of Contact Was Confirmed, While In The Control Group The Occlusal Surfaces Were Left Intact. Standard Endodontic Treatment Was Performed In Two Visits Using Rotary Nickel Titanium Files For Shaping, 2.5% Sodium Hypochlorite For Cleaning And Lateral Condensation Technique With Resin Sealer For Obturation. Pain Was Assessed Preoperatively, Then After 6, 12, 24 And 48 Hours Following Instrumentation, Then After 6 And 12 Hours Following Obturation. Visual Analogue Scale (VAS) Was Used As The Primary Outcome Measure. Patients Were Given A Placebo To Be Administrated In Case Of Severe Pain And Ibuprofen 400mg Was Prescribed In Case Of Persistent Pain. Incidence Of Placebo And Analgesic Intake Was Regarded As The Secondary Outcome. Chi-square And Fisher Exact Tests Were Used To Compare Categorical Data.

Results: The Incidence Of Pain Was Lower In The Intervention Group At All Follow-up Periods. The Difference Between The Two Groups Was Significant At 6 Hours Following Instrumentation. There Was No Significant Difference In Incidences Of Neither Placebo Nor Analgesic Intake Between The Two Groups.

Conclusions: Occlusal Reduction Could Be A Simple Effective Strategy For Controlling Postoperative Pain Incidence Following Root Canal Treatment In Symptomatic Posterior Teeth Having Pulpitis And Apical Periodontitis..