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In the patency group, a #10 K-file was gently extended 1\u00a0mm beyond the working length at each instrument change to maintain AP, whereas in the non-patency group, instrumentation was confined within the working length. All treatments were completed at one visit by a single operator using the One Curve NiTi rotary system (25\/0.06 or 35\/0.04; MicroMega, Besan\u00e7on, France) and standardized irrigation (2.5% NaOCl, 17% EDTA). Pain was recorded on a Numerical Rating Scale (NRS) at 0\u20136, 6\u201312, 12\u201324, 24\u201336, and 36\u201348\u00a0h. The data were analyzed using Mann\u2013Whitney U, \u03c7\u00b2\/Fisher, Friedman, and Generalized Estimating Equations (GEE) tests (\u03b1\u2009=\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The groups did not differ significantly in age, gender, or jaw location (\n                      <jats:italic>p<\/jats:italic>\n                      &gt; .05). The pain scores were similar at all time intervals (\n                      <jats:italic>p<\/jats:italic>\n                      &gt; .05) and decreased significantly over time in both groups (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001). From 12 to 24\u00a0h onward, most patients reported minimal or no pain. Analgesic intake within 48\u00a0h was infrequent and comparable between groups (\n                      <jats:italic>p<\/jats:italic>\n                      &gt; .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In asymptomatic vital single-rooted teeth, maintaining AP did not significantly affect postoperative pain within the first 48\u00a0h after single-visit root canal treatment. Therefore, routine use of AP solely to reduce early postoperative pain is not warranted in this patient group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>For asymptomatic vital single-rooted teeth, AP should not be performed with the expectation of reducing early postoperative pain; its use should be considered based on case-specific clinical considerations rather than pain control alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-06788-w","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T01:01:26Z","timestamp":1772067686000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Does maintaining apical patency reduce early postoperative pain after root canal treatment? 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