The effect of various file systems on postoperative pain in primary Tooth Root Canal treatments: A randomized controlled clinical trial

Objective: All root canal preparation techniques can potentially result in debris protruding apically, leading to postoperative pain. This study aimed to assess the effects of different file systems on postoperative pain in root canal treatments performed on primary molar teeth. Material and Methods: The study included 100 patients aged 5-8 years. NiTi K-type hand files (NTK), rotary file systems ProTaper Next (PTN), AF Baby (AFB), EndoArt Niti Pedo Gold (EAN), and reciprocal file system WaveOne Gold (WOG) were employed in the canal treatment of mandibular primary molars. Postoperative pain was assessed using the Visual Analog Scale (VAS) at the 6th, 12th, 18th, 24th, 48th, 72nd hour, and 1st week following treatment, and the collected data were evaluated statistically. Results: When considering time as a factor, the postoperative pain values among the groups were compared using the Kruskal-Wallis H test, and no statistically significant differences were observed (p = 0.007). In numerical terms, the group using NTK, EAN, AFB, and PTN exhibited the highest average postoperative pain, while the group using WOG, a reciprocal system, had the lowest pain. Conclusion: In conclusion, the choice of file used impacts postoperative pain. There was no statistically significant difference in time-independent postoperative pain values between rotary files designed for primary teeth and those intended for permanent teeth. However, using files specifically designed for primary teeth is recommended, considering factors such as working comfort and suitability for working length.