To evaluate whether maintenance of apical patency has an effect on post-operative pain in symptomatic irreversible pulpitis cases: An in vivo study

• Author Details:   
• Mansi Punjabi
• Sonal Mukhraiya ^*
• Apoorva Sharma
• Rohit Kochhar
• Manju Kumari

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Background: Apical patency refers to the controlled extension of a small, flexible file slightly beyond the apical foramen to prevent debris accumulation and apical blockage during root canal preparation. Its role in influencing postoperative pain remains controversial.

Aim & Objective: To evaluate whether maintaining apical patency affects postoperative pain in patients with symptomatic irreversible pulpitis.

Materials and Methods: This prospective, randomized clinical study was conducted on 30 patients with single-rooted teeth diagnosed with symptomatic irreversible pulpitis. Patients were randomly assigned into two groups: Group A (patency, n=15), where a #10 K-file was extended 1 mm beyond the working length to maintain apical patency; and Group B (non-patency, n=15), where instrumentation was confined to the working length. Postoperative pain was assessed using a Visual Analog Scale (VAS) at baseline, 24 hours, and 48 hours. Data were analyzed using independent t-tests and one-way ANOVA, with a significance level set at p ≤ 0.05.

Results: Both groups demonstrated significant pain reduction over time (p=0.001). However, pain scores were significantly lower in the patency group compared with the non-patency group at 24 hours (p=0.002) and 48 hours (p=0.001).

Conclusion: Maintaining apical patency does not increase postoperative pain; instead, it is associated with a greater reduction in pain compared to non-patency.