Comparative Evaluation of Postoperative Pain Associated with Hand Files, Rotary, and Reciprocal File Systems: An In-Vivo Study

Abstract

Background: Postoperative pain following root canal therapy is influenced by instrumentation technique, apical extrusion of debris, and periradicular inflammation. Newer systems such as HyFlex EDM (rotary) and Reciproc Blue (reciprocation) claim to minimize debris extrusion compared to traditional hand files.

Aim: To compare postoperative pain following root canal instrumentation using Hand K-files, HyFlex EDM rotary files, and Reciproc Blue reciprocal systems.

Materials and Methods: A randomized controlled clinical trial was conducted on 60 patients aged 18–50 years requiring root canal treatment in single-rooted teeth with symptomatic irreversible pulpitis. Patients were randomly divided into three groups (n=20 each): Group I: Hand K-files (step-back), Group II: HyFlex EDM (rotary), Group III: Reciproc Blue (reciprocation) Pain intensity was recorded using a Visual Analog Scale (VAS: 0–10) at 6 h, 12 h, 24 h, 48 h, and 72 h post-instrumentation. Standardized irrigation, obturation, and analgesic protocol were followed. Data were analyzed using ANOVA and post-hoc Tukey tests (p < 0.05).

Results: At all postoperative intervals, Reciproc Blue showed the lowest mean pain scores, followed by HyFlex EDM, while Hand files showed the highest pain levels. The difference was statistically significant at 12 h, 24 h, and 48 h (p < 0.05). By 72 h, pain levels in all groups were minimal with no significant difference.

Conclusion: Reciproc Blue files resulted in significantly less postoperative pain compared to Hand files and HyFlex EDM rotary systems. Reciprocation may reduce debris extrusion and inflammatory response, leading to better postoperative comfort.