Assessment of Post-operative Pain after using EdgeFile X7 and Protaper Next Rotary Systems in Patients with Symptomatic Pulpitis in Mandibular Molars: A Randomized Controlled Clinical Trial


  • Adel Abdelwahed Department of Endodontics, Future University in Egypt, New Cairo, Egypt
  • Nehal Nabil Roshdy Department of Endodontics, Cairo University, Cairo, Egypt



Edge file X7, Post-operative pain, ProTaper next, Randomized clinical trial, Single visit, Symptomatic pulpitis


AIM: The aim of the study was to evaluate the incidence of post-operative pain and analgesics intake after single-visit endodontic treatment using Edge File X7 and ProTaper Next (PTN) rotary files in mandibular molars having symptomatic pulpitis.

METHODS: The study included 60 patients complaining of symptomatic pulpitis in mandibular molar teeth. After confirming the diagnosis clinically and radiographically, patients were assigned into two equal groups; Group (I): Instrumentation was done with Edge File X7 (EF) rotary files and Group (II): Instrumentation was done with PTN rotary files. The patients underwent standardized single visit endodontic treatment procedures using 2.5% sodium hypochlorite for irrigation. Modified visual analogue scale was used to access pain preoperatively, and then postoperatively after 6, 12, 24, 48, and 72 h. An analgesic (ibuprofen 400 mg) was prescribed to the patient who suffered from persistent pain. The incidence and/or number of analgesic tablets intake were recorded. Data of pain score were compared using Mann–Whitney U test for intergroup comparisons and Freidman’s test followed by Dunn’s post hoc test for intragroup comparisons.

RESULTS: No statistically significant difference was detected between EF and PTN groups regarding the incidence and intensity of pain at different time intervals (p > 0.05). There was a significant reduction in the mean VAS score through the follow-up periods in both groups (p < 0.001). The incidence of analgesic intake was not significant in both groups.

CONCLUSION: The incidence of post-operative pain and the analgesic intake in terms of frequency and quantity were found to be similar with both rotary systems for all the post-operative time points.


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Ince B, Ercan E, Dalli M, Dulgergil CT, Zorba YO, Colak H. Incidence of postoperative pain after single-and multi-visit endodontic treatment in teeth with vital and non-vital pulp.Eur J Dent. 2009;3(4):273-9. PMid:19826598 DOI:

Pak JG, White SN. Pain prevalence and severity before, during, and after root canal treatment: A systematic review. J Endod. 2011;37(4):429-38. PMid:21419285 DOI:

Siqueira JF Jr., Rôças IN, Favieri A, Machado AG, Gahyva SM, Oliveira JC, et al. Incidence of postoperative pain after intracanal procedures based on an antimicrobial strategy. J Endod. 2002;28(6):457-60. PMid:12067129 DOI:

Kirchhoff AL, Fariniuk LF, Mello I. Apical extrusion of debris in flat-oval root canals after using different instrumentation systems. J Endod. 2015;41(2):237-41. PMid:25447504 DOI:

Kalra P, Rao A, Suman E, Shenoy R, Suprabha BS. Evaluation of conventional, protaper hand and protaper rotary instrumentation system for apical extrusion of debris, irrigants and bacteria-An in vitro randomized trial. J Clin Exp 2017;9(2):e254-8. PMid:28210445 DOI:

Kherlakian D, Cunha RS, Ehrhardt IC, Zuolo ML, Kishen A, Da Silveira Bueno CE. Comparison of the incidence of postoperative pain after using 2 reciprocating systems and a continuous rotary system: A prospective randomized clinical trial. J Endod. 2016;42(2):171-6. PMid:26614017 DOI:

Ruddle CJ, Machtou P, West JD. The shaping movement: Fifth-generation technology. Dent Today. 2013;32(4):22-8. PMid:23659098

Gambrini G, Galli M, Seracchiani M, Di Nardo D, Versiani MA, Piasecki L, et al. In vivo evaluation of operative torque generated by two nickel-titanium rotary instruments during root canal preparation. Eur J Dent. 2019;13(4):556-62. PMid:31891973 DOI:

Arias A, la Macorra J, Hidalgo J, Azabal M. Predictive models of pain following root canal treatment: A prospective clinical study. Int Endod J. 2013;46(8):784-93. PMid:23402273 DOI:

García-Ramírez PE, González-Rodríguez SG, Soto-Acevedo F, Brito-Zurita OR, Cabello-Molina R, López-Morales CM. Postoperative pain: Frequency and management characterization. Rev Colomb Anestesiol. 2018;46(2):93-7. DOI:

Del Fabbro M, Afrashtehfar KI, Corbella S, El-Kabbaney A, Perondi I, Taschieri S. In vivo and in vitro effectiveness of rotary nickel-titanium vs manual stainless-steel instruments for root canal therapy: Systematic review and meta-analysis. J Evid Based Dent Pract. 2018;18:56-69. PMid:29478682 DOI:

Siqueira J, Barnett F. Interappointment pain: Mechanisms, diagnosis, and treatment. Endod Top. 2004;7:93-109. DOI:

Kustarcı A, Akpınar KE, Er K. Apical extrusion of intracanal debris and irrigant following use of various instrumentation techniques. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(2):257-62. PMid:18230395 DOI:

Fernández-Pazos G, Martín-Biedma B, Varela-Patiño P, Ruíz-Piñón M, Castelo-Baz P. Fracture and deformation of ProTaper Next instruments after clinical use. J Clin Exp. 2018;10(11):e1091. PMid:30607226 DOI:

Moreira MS, Anuar AS, Tedesco TK, dos Santos M, Morimoto S. Endodontic treatment in single and multiple visits: An overview of systematic reviews. J Endod. 2017;43(6):864-70. PMid:28457639 DOI:

Rao KN, Kandaswamy R, Umashetty G. Post-obturation pain following one-visit and two-visit root canal treatment in necrotic anterior teeth. Smile Dent J. 2014;9(2):44-4. PMid:24876699 DOI:

Ramamoorthi S, Nivedhitha MS, Divyanand MJ. Comparative evaluation of postoperative pain after using endodontic needle and EndoActivator during root canal irrigation: A randomised controlled trial. Aust Endod J. 2015;41(2):78-87. PMid:25195661 DOI:

Nabil N, Elnahas KA,Yacoub S. Post-operative pain after single visit root canal treatment in necrotic teeth using two different rotary systems protaper next and neolix: A randomized clinical trial. Acta Sci Dent Sci. 2019;3(4):110-5.

Williamson A, Hoggart B. Pain : A review of three commonly used pain rating scales. J Clin Nurs. 2005;14(7):798-804. PMid:16000093 DOI:

Gufran AS, Sanjyot M, Aparna P, Deepak S, Anurag J, Hina G. Prevalence of and factors affecting post obturation pain following single visit root canal treatment in Indian population : A prospective, randomized clinical trial. Contemp Clin Dent. 2012;3(4):459-63. PMid:23633809 DOI:

Dubin AE, Patapoutian A. Nociceptors: The sensors of the pain pathway. J Clin Investig. 2010;120(11):3760-72. PMid:21041958 DOI:

Ng, Y, Glennon JP, Setchell DJ, Gulabivala K. Prevalence of and factors affecting post-obturation pain in patients undergoing root canal treatment. Int Endod J. 2004;37(6):381-91. PMid:15186245 DOI:

Koçak S, Sen OG, Bilgin B, Can B. Evaluation of apically extruded debris using continuous rotation, reciprocation, or adaptive motion. Braz Dent J. 2018;29(3):245-8. PMid:29972449 DOI:

Yılmaz N, Sa BC. Apical extrusion of debris using ProTaper universal and ProTaper Next rotary systems. Int Endod J. 2015;48(3):283-6. PMid:24863544 DOI:

Capar ID, Arslan H, Akcay M, Ertas H. An in vitro comparison of apically extruded debris and instrumentation times with protaper universal, protaper next, twisted file adaptive, and hyflex instruments. J Endod. 2014;40(10):1638-41. PMid:25260737 DOI:

Çiçek E, Koçak MM, Koçak S, Sağlam BC, Türker SA. Postoperative pain intensity after using different instrumentation techniques: A randomized clinical study. J Appl Oral Sci 2017;25(1):20-6. PMid:28198972 DOI:

Khalil WA, Merdad K, Abu-Haimed TS, Howait M, Alsofi L. Cyclic fatigue resistance of protaper gold, Edgefile, oneshape and protaper universal. Egyp Dent J. 2018;64(1):589-96. DOI:

Ansari I, Maria R. Managing curved canals. Contemp Clin Dent. 2012;3(2):237-41. PMid:22919234 DOI:

Gambarini G, Testarelli L, Milana V, Pecci R, Bedini R, Pongione G, et al. Angular deflection of rotary nickel titanium files: A comparative study. Ann Ist Super Sanita. 2009;45(4):423-6. PMid:20061663 DOI:

Koch K, Brave D. Real world Endo: Design features of rotary files and how they affect clinical performance. Oral Health. 2002;92:39-49.

Pozzi A, Gallelli L. Pain management for dentists: The role of ibuprofen. Ann Stomatol (Roma). 2011;2(3-4):3-24. PMid:22888399

Shirvani A, Shamszadeh, S, Eghbal MJ, Asgary S. The efficacy of non-narcotic analgesics on post-operative endodontic pain: A systematic review and meta-analysis: The efficacy of non-steroidal anti-inflammatory drugs and/or paracetamol on post-operative endodontic pain. J Oral Rehabil. 2017;44(9):709-21. PMid:28449307 DOI:




How to Cite

Abdelwahed A, Roshdy NN. Assessment of Post-operative Pain after using EdgeFile X7 and Protaper Next Rotary Systems in Patients with Symptomatic Pulpitis in Mandibular Molars: A Randomized Controlled Clinical Trial. Open Access Maced J Med Sci [Internet]. 2022 Jan. 2 [cited 2024 Apr. 12];10(D):57-63. Available from:



Dental Pathology and Endodontics