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Abstract
Objective: The purpose of this study was to evaluate the effect of occlusal reduction for mandibular posterior teeth on the incidences of post-instrumentation and post-obturation pain in patients with symptomatic irreversible pulpitis and symptomatic apical periodontitis. Participants and methods: 44 patients were included in the study. All patients had posterior mandibular teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis without peri-apical radiolucency in the radiograph. The patients were divided randomly into two equal groups, each group included 22 participants. For the intervention group, all the occlusal contacts were relieved from occlusion, while for the control group, no modification was done for the occlusal surface of the tooth. The root canal treatment was done in two visits where root canals were prepared by Revo S rotary NiTi files while obturation was done using modified single cone in the second visit. The pain was assessed preoperatively, 6, 12, 24 and 48 hours after the instrumentation, then 6 and 12 hours after the obturation using modified visual analogue scale (VAS). Patients were given a placebo to be taken in case of moderate or severe pain and ibuprofen 400mg was prescribed in case of persistent pain. Data were analyzed using chi-square and fisher exact tests. Mann-whitney U test was used to compare between the pain value in the two groups. Results: The results of the study showed that, there is significant decrease in the mean VAS scores at all follow up periods compared to pre-operative pain level in the two groups, but postoperative pain intensity was higher with occlusal reduction group than with no occlusal reduction (post-instrumentation) with no statistical significance