Effect of Occlusal Reduction on Pain in Posterior Teeth with Necrosis and Apical Periodontitis: A Randomized Controlled Trial.

INTRODUCTION: This randomized controlled trial evaluated the impact of occlusal reduction on postoperative pain after chemomechanical preparation. MATERIALS AND METHODS: 102 asymptomatic teeth with pulp necrosis and apical periodontitis were randomly allocated to two equal groups: the control group (NOR) and the occlusal reduction (OR) group. The root canal treatment was performed according to a predefined standardized protocol. Patients were prescribed Ibuprofen 400 mg to be consumed 8 hourly, if required. Postoperative pain and analgesic consumption were documented for 7 days following chemomechanical preparation. The data analysis was performed using Mann-Whitney U and Chi-square tests. RESULTS: A significant postoperative pain difference was found between the two groups on the first 3 days, with higher pain observed in NOR as compared to OR (p < 0.05). The prevalence of pain was higher in NOR (47.06%) as compared to OR group (29.41%), but the difference was not significant (p > 0.05). No significant differences were observed in the mean number of analgesic doses consumed and the prevalence of analgesic intake between the two groups (p > 0.05). CONCLUSION: Postoperative pain incidence was comparable in the two groups. The difference in postoperative pain intensity was statistically significant on the first 3 days. The reduction observed, however, lacked clinical relevance. HOW TO CITE THIS ARTICLE: Sangwan P, Saini HR, Sangwan A. Effect of Occlusal Reduction on Pain in Posterior Teeth with Necrosis and Apical Periodontitis: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2026;19(8):957-962.