الفهرس 
Title : Effect of Occlusal Reduction on Postoperative Pain in Teeth with Irreversible Pulpitis and Symptomatic Apical Periodontitis: A Randomized Clinical Trial
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Abstract
The effect of occlusal reduction on postoperative pain after root canal instrumentation and obturation was evaluated in this study; a randomized clinical trial. Methods: Forty-four patients complaining from symptomatic irreversible pulpitis with symptomatic apical periodontitis in posterior mandibular teeth were included. After confirming the diagnosis clinically and radiographically, patients were randomly assigned into two equal groups of 22 patients each. The occlusal surfaces of teeth assigned to the intervention group were reduced and absence of contact was confirmed; while occlusal contacts were left intact in those assigned to the control group. Standard endodontic treatment was performed in two visits using rotary nickel-titanium files for shaping, 2.5% sodium hypochlorite for cleaning and modified single cone technique with resin sealer for obturation. Pain was assessed pre-operatively, then after 6, 12, 24 and 48 hours after root canals instrumentation, and after 6 and 12 hours following root canal obturation. Visual Analogue Scale (VAS) was used as the primary outcome measure. Patients were given a placebo to be administrated in case of moderate to severe pain and an analgesic was prescribed in case of persistent pain. All demographic data and VAS scores were collected from the patients and were statistically analyzed. Results: Results showed that, There was a statistically significant decrease in median modified VAS scores of preoperative pain compared with post instrumentation pain after 6, 12, 24 and 48 hours in two groups. These results were statistically insignificant between the 2 groups. There was also no significant difference in incidence of analgesic intake between the two groups. Conclusion: Occlusal reduction is not an effective procedure to reduce postoperative pain in teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis , still the controversy is present