Patient-Centered Outcomes in Endodontics: Does the Irrigation System Impact Postoperative Pain?

Abstract

The importance of patient-centered outcomes in endodontics has been on the rise, and postoperative pain is considered to be among the most appropriate tools of measuring treatment success. The systems and methods of activation of irrigation have a significant role in cleaning and disinfecting the root canal system but can also contribute to postoperative discomfort due to factors like extrusion of debris, penetration of irrigant and periapical irritation. This review examines the association between irrigation systems such as conventional syringe irrigation, ultrasonic and sonic activation, laser-activated irrigation and negative pressure system and postoperative pain after root canal therapy. The randomized clinical trials have shown evidence that activated irrigation techniques, especially negative pressure and some laser or ultrasonic techniques, correlate with low levels of pain in the early postoperative period as opposed to the traditional needle irrigation. Nevertheless, the disparity in the results of pain are likely to decrease with time and the inconsistency in the study procedures further underscores the necessity of additional standardized clinical studies. The effects of irrigation strategies on patient-centered outcomes can inform clinicians to choose methods that effectively disinfect, as well as, increase patient comfort and experience, in general, of the treatment.