Evaluation of postoperative pain after endodontic treatment under irrigation with 2.5% or 5.25% Sodium Hypochlorite





Irrigation; Postoperative pain; Pulp necrosis; Solution concentration.


Objective: to evaluate pain symptoms in patients after endodontic treatment of teeth with pulp necrosis under irrigation with 2.5% or 5.25% sodium hypochlorite. Methods: 50 single-rooted maxillary anterior teeth were divided into two groups (n=25). Group HS2: teeth with pulp necrosis rinsed with 2.5% sodium hypochlorite, Group HS5: teeth with pulp necrosis rinsed with 5.25% sodium hypochlorite. All canals were instrumented with Reciproc R25 or R40 or R50 files, depending on the initial diameter, according to the manufacturer's instructions, and rinsed with 10 mL of solution in each third. At the end, the Easy Clean tip was used, performing 03 cycles of 20s each with 1 mL of 17% EDTA, then 2 mL of 2.5% NaOCl for group HS2 and 5.25% for group HS5, shaking for 3 cycles of 20s. The canals were dried and filled using the single cone technique with AH Plus endodontic cement and sealed with provisional material and glass ionomer. After treatment, patients answered a questionnaire at 24h, 48h, 72h and 07 days post-treatment using the VAS pain scale, which ranks pain intensity from 0 to 10. Data were analyzed using the Biotest 5.0 program and subjected to the Shapiro-Wilk normality test. The sample showed non-parametric behavior and the Kruskal-Walis test was used with a significance level of 5%. Results: There was no statistically significant difference regarding postoperative pain in the scores of VAS scale at 24h, 48h, 72h and 7 days after treatment with sodium hypochlorite at 2.5% and 5.25% (p > 0.05). Pain was mild in both groups. Conclusion: We conclude that 2.5% and 5.25% sodium hypochlorite solutions did not affect the pain level after endodontic treatments.


Barciela, B., da Silva Limoeiro, A. G., Bueno, C. E., Fernandes, S. L., Mandarini, D. R., Boer, N. C., ... & Rocha, D. G. (2019). In vivo evaluation of painful symptomatology after endodontic treatment with or without the use of photodynamic therapy. Journal of Conservative Dentistry: JCD, 22(4), 332.

Baumgartner, J. C., & Cuenin, P. R. (1992). Efficacy of several concentrations of sodium hypochlorite for root canal irrigation. Journal of endodontics, 18(12), 605-612.

Bueno, C. S. P., de Oliveira, D. P., Pelegrine, R. A., Fontana, C. E., Rocha, D. G. P., & da Silveira Bueno, C. E. (2017). Fracture incidence of WaveOne and Reciproc files during root canal preparation of up to 3 posterior teeth: a prospective clinical study. Journal of endodontics, 43(5), 705-708.

Camões I, Freitas L, Santiago C, Gomes C, Menezes F.(2012) Analysis of concentration and ph of various trademarks of sodium hypochlorite.1(24): 15-8.

de-Figueiredo, F. E. D., Lima, L. F., Lima, G. S., Oliveira, L. S., Ribeiro, M. A., Brito-Junior, M., ... & Faria e Silva, A. L. (2020). Apical periodontitis healing and postoperative pain following endodontic treatment with a reciprocating single-file, single-cone approach: a randomized controlled pragmatic clinical trial. Plos one, 15(2), e0227347.

Demenech, L. S., de Freitas, J. V., Tomazinho, F. S. F., Baratto-Filho, F., & Gabardo, M. C. L. (2021). Postoperative pain after endodontic treatment under irrigation with 8.25% sodium hypochlorite and other solutions: a randomized clinical trial. Journal of Endodontics, 47(5), 696-704.

Farzaneh, S., Parirokh, M., Nakhaee, N., & Abbott, P. V. (2018). Effect of two different concentrations of sodium hypochlorite on postoperative pain following single‐visit root canal treatment: a triple‐blind randomized clinical trial. International endodontic journal, 51, e2-e11.

Gavini, G., Caldeira, C. L., Akisue, E., de Miranda Candeiro, G. T., & Kawakami, D. A. S. (2012). Resistance to flexural fatigue of Reciproc R25 files under continuous rotation and reciprocating movement. Journal of Endodontics, 38(5), 684-687.

Haapasalo, M., Shen, Y., Wang, Z., & Gao, Y. (2014). Irrigation in endodontics. British dental journal, 216(6), 299-303.

Harrison, J. W., Baumgartner, I. C., & Zielke, D. R. (1981). Analysis of interappointment pain associated with the combined use of endodontic irrigants and medicaments. Journal of endodontics, 7(6), 272-276.

Jayakodi, H., Kailasam, S., Kumaravadivel, K., Thangavelu, B., & Mathew, S. (2012). Clinical and pharmacological management of endodontic flare-up. Journal of pharmacy & bioallied sciences, 4(Suppl 2), S294.

Jeansonne, M. J., & White, R. R. (1994). A comparison of 2.0% chlorhexidine gluconate and 5.25% sodium hypochlorite as antimicrobial endodontic irrigants. Journal of endodontics, 20(6), 276-278.

Karcioglu, O., Topacoglu, H., Dikme, O., & Dikme, O. (2018). A systematic review of the pain scales in adults: which to use?. The American journal of emergency medicine, 36(4), 707-714.

Kato, A. S., Cunha, R. S., da Silveira Bueno, C. E., Pelegrine, R. A., Fontana, C. E., & de Martin, A. S. (2016). Investigation of the efficacy of passive ultrasonic irrigation versus irrigation with reciprocating activation: an environmental scanning electron microscopic study. Journal of endodontics, 42(4), 659-663.

Lopes, H. P., Martins, C. M., Carvalho, R. D. M., Siqueira Júnior, J. F., & Cabreira, M. S. (1999). Análise de diversas marcas de água sanitária: confiabilidade e segurança para uso como soluçäo química auxiliar em endodontia. Rev. bras. odontol, 319-22.

Lopes, L. P. B., Herkrath, F. J., Vianna, E. C. B., Gualberto Júnior, E. C., Marques, A. A. F., & Sponchiado Júnior, E. C. (2019). Effect of photobiomodulation therapy on postoperative pain after endodontic treatment: a randomized, controlled, clinical study. Clinical oral investigations, 23(1), 285-292.

Madhusudhana, K., Mathew, V. B., & Reddy, N. M. (2010). Apical extrusion of debris and irrigants using hand and three rotary instrumentation systems–An in vitro study. Contemporary clinical dentistry, 1(4), 234.

Milano, N. F., Girardi, V., Bergold, A. M., & Chiapini, L. G. (1991). Alguns aspectos do uso do hipoclorito de sódio em Endodontia. Revista da Faculdade de Odontologia de Porto Alegre. Porto Alegre. vol. 32, n. 1 (jul. 1991), p. 7-10.

Rosenfeld, E. F., James, G. A., & Burch, B. S. (1978). Vital pulp tissue response to sodium hypochlorite. Journal of endodontics, 4(5), 140-146.

Sipavičiūtė, E., & Manelienė, R. (2014). Pain and flare-up after endodontic treatment procedures. Stomatologija, 16(1), 25-30.

Siqueira Jr, J. F., Rôças, I. N., Favieri, A., & Lima, K. C. (2000). Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite. Journal of endodontics, 26(6), 331-334.

Tavares, S. G., Fontana, C. E., De Martin, A. S., Pinheiro, S. L., Pelegrine, R. A., & Rocha, D. G. P. (2020). In vivo evaluation of painful symptomatology after endodontic treatment performed using two different irrigation needle insertion depths. European Journal of Dentistry, 14(02), 274-280.

Tomazinho L, Da Silva D, Fagundes S, Tomazinho P. (2007) In vitro study of antimicrobial activity of irrigating solutions in the elimination of Enterococcus faecalis. Revista Sul Brasileira de Odontologia; 4(1): 12-16.

Vaudt, J., Bitter, K., Neumann, K., & Kielbassa, A. M. (2009). Ex vivo study on root canal instrumentation of two rotary nickel–titanium systems in comparison to stainless steel hand instruments. International endodontic journal, 42(1), 22-33.

Yared, G. (2008). Canal preparation using only one Ni‐Ti rotary instrument: preliminary observations. International endodontic journal, 41(4), 339-344.




How to Cite

RODRIGUES, G. S. S. .; BUENO, C. E. da S.; MARTIN, A. S. de .; FONTANA, C. E.; PINHEIRO, S. L.; PELEGRINE, R. A.; ROCHA, D. G. P. Evaluation of postoperative pain after endodontic treatment under irrigation with 2.5% or 5.25% Sodium Hypochlorite . Research, Society and Development, [S. l.], v. 11, n. 7, p. e16011729788, 2022. DOI: 10.33448/rsd-v11i7.29788. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/29788. Acesso em: 2 mar. 2024.



Health Sciences