Postoperative pain after the application of two different irrigation devices in a prospective randomized clinical trial

By Gondim E Jr, Setzer FC, Dos Carmo CB, Kim S

Date: 10/2011
Journal: JOE


Purpose:  to evaluate and compare the postoperative pain after the use of two different irrigation protocols (standard and EndoVac).

N= 80 patients (110 teeth). Inclusion criteria:  single-rooted teeth with one canal, asymptomatic irreversible

pulpitis caused by carious exposures or normal pulp if the patient had been referred for intentional endodontic therapy for prosthetic reasons. Exclusion: pts with systemic diseases or who took analgesics at the initiation of RCT.


•The teeth were randomly assigned to two groups. In the MP group (n = 55), procedures were performed using an endodontic irrigating syringe (Max-i-Probe), In the EV group (n = 55), an irrigation device based on negative apical pressure (EndoVac) was used.

•For all the teeth, chemomechanical preparation was performed using hand & Protaper rotary instruments. All the teeth received the same volume of irrigants (130 ml 2.5% NaOCL). In MP group, the needle was insterted 2 mm short from WL. In EV group, the needle was inserted to WL.

•Pain levels were assessed by an analog scale questionnaire after 4, 24, and 48 hours. The amount of ibuprofen taken was recorded at the same time intervals.

Most highlighted Results: 

•During the 0- to 4-, 4- to 24-, and 24- to 48-hour intervals after treatment, the pain experience with the negative apical pressure device was significantly lower than when using the needle irrigation (p < 0.0001). •Between 0 and 4 and 4 and 24 hours, the intake of analgesics was significantly lower in the group treated by the negative apical pressure device (p < 0.0001)

Clinical significance: 

The use of a negative apical pressure irrigation device can result in a significant reduction of postoperative pain levels in comparison to conventional needle irrigation.