Frequency of Post-Instrumentation Symptoms Using Hand Files Versus Rotary Protapers

Abstract

Introduction
Controversy among dentists exists to use conventional hand files or contemporary rotary protapers for intracanal instrumentation.
The controversy arose because of variable findings on post-instrumentation pain felt by the under treatment patient that acts as a
deterrent to receive further endodontic treatment. This study has been planned to assess post-instrumentation pain, swelling, tenderness
or redness using the hand files and rotary protapers in confined environment where rubber dam is not used for operative
field isolation from oral fluids.
Material and Methods
One hundred and sixty vital and non-vital teeth were root treated. The subjects were randomly divided into two groups. “Group
A” was treated using hand files with step-back technique and “Group B” with rotary protapers. All the root therapies were accomplished
in two or multiple visits depending on the satisfactory disinfection of the canal. Access to pulp chambers was obtained
using sterile bur without rubber dam isolation and the preparation in either group was performed under normal saline irrigation.
Drying of canal was obtained using paper points followed by cotton and temporary packing to ensure tight leak proof coronal
seal and the subjects were recalled on subsequent day.
Results
Results revealed that the highest symptomatic adversity was faced by n=40 subjects with non-vital pulps after hand filing. Least
frequent symptomatic complaints were made by the group with vital pulps and were treated by rotary protapers. In vital teeth, pain
was reported more in hand filed teeth than in teeth that were treated with protapers. Non-vital teeth showed a similar pattern with
greater number of complaints about pain in both hand filed and protaper subjects.
Conclusion
Rotary protapers induced less post-instrumentation symptoms than hand files in vital as well as non-vital teeth.