Use of higher concentrations of NaOCl as irrigant during RCT linked to postendodontic pain, suggests study

Results: Five randomized controlled trials with 674 patients were included. One study exhibited a low risk of bias, while 4 raised some concerns. Patients treated with low concentrations of NaOCl (≤3%) were significantly less likely to report PEP at 24 hours (OR = 2.32; [95% CI, 1.63–3.31]; P < .05) and 48 hours (OR = 2.49; [95% CI, 1.73–3.59]; P < .05) as compared with high concentrations of NaOCl (≥5%). Furthermore, with low concentrations of NaOCl, significantly lesser moderate-severe PEP was reported at 24 hours (OR = 2.32; [95% CI, 1.47–3.62]; P < .05) and 48 hours (OR = 2.35; [95% CI, 1.32–4.16]; P < .05) and lesser analgesia was needed (OR = 2.43; [95% CI, 1.48–4.00]; P < .05).

While PEP can be influenced by several factors, low certainty evidence suggests that when NaOCl is used as an irrigant during RCT, PEP may be less likely with lower concentrations of NaOCl. Moderate certainty evidence indicates that lesser analgesia may be required with lower concentrations of NaOCl. These results should be cautiously interprete

Reference:

Sodium Hypochlorite Concentration and Postendodontic Pain - Unveiling the Optimal Balance: A Systematic Review and Meta-Analysis. Prasad, Niharika et al.. Journal of Endodontics, Volume 50, Issue 9, 1233 - 1244