Evaluation of postoperative pain with new heat-treated rotary and reciprocating nickel-titanium files: A randomized controlled clinical trial

Introduction: A special heat-treated endodontic file (TruNatomy) was recently introduced with the claim of superior flexibility to enhance dentin preservation. The aim of the present study was to assess postoperative pain in single-visit root canal treatment with this newly introduced file, comparing it with other contemporary reciprocating and rotary file systems. Materials and Methods: One hundred seventy patients with acute irreversible pulpitis in maxillary premolars were randomly assigned to four experimental file systems: TruNatomy, HyFlex EDM, EdgeFile, and ProTaper Gold. Pre- and postoperative pain scores were assessed with 10-point visual analog scale. Data were statistically analyzed using Kruskal-Wallis test. Results: TruNatomy file system had significantly the highest postoperative pain incidence (53.8%), while the EdgeFile system had significantly the least postoperative pain incidence (24%) and 24-h pain score. Conclusion: The present study demonstrated that the reciprocating multiple-file system, EdgeFile, had significantly reduced postoperative pain incidence compared to other heat-treated rotary nickel-titanium file systems.