{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:53:29Z","timestamp":1792806809931,"version":"4.5.0"},"reference-count":69,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical &amp; Exp Dental Res"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to compare the effects of three irrigation activation systems (IAS) on postoperative pain (PP) in activating three final irrigants: sodium hypochlorite 5.25%, ethylenediaminetetraacetic acid 17%, and chlorhexidine 2%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This parallel randomized clinical trial included referred patients with asymptomatic large\u2010sized apical lesion incisors. A standard method was followed in the canal cleaning and shaping for all included patients in the study. Then, the patients were randomly assigned (1:1 allocation) into three groups: G1 (<jats:italic>n<\/jats:italic>\u2009=\u200920) with passive ultrasonic irrigation activation; G2 (<jats:italic>n<\/jats:italic>\u2009=\u200920) with XP\u2010Endo Finisher file activation; and G3 (<jats:italic>n<\/jats:italic>\u2009=\u200920) with diode laser (810\u2009nm) activation. PP was estimated in all groups using a visual analog scale after 1, 3, 7, and 14 days of treatment. Comparisons between the groups were made using the Kruskal\u2212Wallis test, whereas the Mann\u2212Whitney <jats:italic>U<\/jats:italic> test was used in the pairwise comparisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty patients were followed\u2010up in this trial. There were significant differences between the groups in terms of PP After 1, 3, and 7 days of treatment (<jats:italic>p<\/jats:italic>\u2009=\u20090.002, <jats:italic>p<\/jats:italic>\u2009=\u20090.017, and <jats:italic>p<\/jats:italic>\u2009=\u20090.006, respectively). On the first day of treatment, G3 showed the lowest PP compared with G1 and G2 (<jats:italic>p<\/jats:italic>\u2009=\u20090.007 and <jats:italic>p<\/jats:italic>\u2009=\u20090.001, respectively). On the third day of treatment, G3 showed less PP compared with G2 (<jats:italic>p<\/jats:italic>\u2009=\u20090.005). On the seventh day of treatment, G2 showed the highest PP compared with G1 and G3 (<jats:italic>p<\/jats:italic>\u2009=\u20090.012 and <jats:italic>p<\/jats:italic>\u2009=\u20090.003, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The XP\u2010Endo Finisher file caused the highest PP level especially in the next day and 3 days of the treatment, whereas the diode laser had the lowest PP level during the first week of treatment. It is noteworthy that PP disappeared completely after 2 weeks of treatment with all three IASs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>The trial was registered in the ISRCTN registry (Trial ID: SRCTN99457940).<\/jats:p><\/jats:sec>","DOI":"10.1002\/cre2.786","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T07:41:37Z","timestamp":1696318897000},"page":"868-878","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The effect of the irrigant activation protocol on postoperative pain in maxillary incisors with asymptomatic apical periodontitis: A three\u2010arm randomized clinical trial"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3664-0248","authenticated-orcid":false,"given":"Mohammad Tamer","family":"Abbara","sequence":"first","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry 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Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghina","family":"Mahayni","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry Al\u2010Sham Private University Damascus Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5498-9991","authenticated-orcid":false,"given":"Yasser Alsayed","family":"Tolibah","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry, Faculty of Dentistry Damascus University Damascus Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.14744\/eej.2022.39200"},{"key":"e_1_2_11_3_1","first-page":"84","article-title":"Influence of irrigating solution on postoperative pain following single\u2010visit endodontic treatment: Randomized clinical trial","volume":"78","author":"Almeida 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