Severity of post-operative pain after instrumentation of root canals by XP-Endo and SAF full sequences compared to manual instrumentation: a randomized clinical trial

This investigation aimed to examine the post-operative pain experienced following single-visit root canal treatment using the XP-endo shaper sequence (XPS), full-sequence self-adjusting file (SAF), and manual K-files (HKF). A randomized equivalence parallel design, double-blinded clinical study was conducted on 120 patients with symptomatic irreversible pulpitis, with or without clinical signs of apical periodontitis. Only teeth with fully formed roots and no periapical lesions were incorporated in the study. Patients were apportioned to one of three groups (n = 40) randomly: Group 1—XPS, Group 2—SAF, and Group 3—HKF. Pre- and post-instrumentation pain was rated utilizing Visual Analog Scale (VAS) with a spectrum of 0–100 mm. The descriptive statistics and one-way ANOVA with 95% confidence intervals were used for statistical analysis. The mean VAS scores before instrumentation were consistent in all three groups. At 6, 24, 48, and 72 h, patients with root canals instrumented by SAF had the lowest post-instrumentation mean VAS score, followed by XPS. For all time intervals, the patients in the HKF group had the highest VAS score. The full-sequence SAF instrumentation resulted in less post-operative pain than the XP-endo plus protocol, while manual instrumentation with K-files resulted in the highest post-operative pain.