Postoperative pain after root canal treatment: a prospective cohort study

M Gotler, B Bar-Gil, M Ashkenazi, M Gotler, B Bar-Gil, M Ashkenazi

Abstract

Aim. To evaluate the incidence and severity of postendodontic treatment pain (PEP) subsequent to root canal treatment (RCT) in vital and necrotic pulps and after retreatment. Methodology. A prospective study. Participants were all patients (n = 274) who underwent RCT in teeth with vital pulp, necrotic pulp, or vital pulp that had been treated for symptomatic irreversible pulpitis or who received root canal retreatment, by one clinician, during an eight-month period. Exclusion criteria were swelling, purulence, and antibiotic use during initial treatment. A structured questionnaire accessed age, gender, tooth location, and pulpal diagnosis. Within 24 h of treatment, patients were asked to grade their pain at 6 and 18 hours posttreatment, using a 1-5 point scale. Results. RCT of teeth with vital pulp induced a significantly higher incidence and severity of PEP (63.8%; 2.46 ± 1.4, resp.) than RCT of teeth with necrotic pulp (38.5%; 1.78 ± 1.2, resp.) or of retreated teeth (48.8%; 1.89 ± 1.1, resp.). No statistical relation was found between type of pain (spontaneous or stimulated) and pulp condition. Conclusion. RCT of teeth with vital pulp induced a significantly higher incidence and intensity of PEP compared to teeth with necrotic pulp or retreated teeth.

References

    1. van Wijk AJ, Hoogstraten J. Reducing fear of pain associated with endodontic therapy. International Endodontic Journal. 2006;39(5):384–388.
    1. van Wijk AJ, Duyx MPMA, Hoogstraten J. The effect of written information on pain experience during periodontal probing. Journal of Clinical Periodontology. 2004;31(4):282–285.
    1. Levin L, Amit A, Ashkenazi M. Post-operative pain and use of analgesic agents following various dental procedures. American Journal of Dentistry. 2006;19(4):245–247.
    1. Ashkenazi M, Blumer S, Eli I. Post-operative pain and use of analgesic agents in children following intrasulcular anaesthesia and various operative procedures. British Dental Journal. 2007;202(5, article E13)
    1. Imura N, Zuolo ML. Factors associated with endodontic flare-ups: a prospective study. International Endodontic Journal. 1995;28(5):261–265.
    1. Tsesis I, Faivishevsky V, Fuss Z, Zukerman O. Flare-ups after endodontic treatment: a meta-analysis of literature. Journal of Endodontics. 2008;34(10):1177–1181.
    1. Mor C, Rotstein I, Friedman S. Incidence of interappointment emergency associated with endodontic therapy. Journal of Endodontics. 1992;18(10):509–511.
    1. Harrison JW, Craig Baumgartner J, Svec TA. Incidence of pain associated with clinical factors during and after root canal therapy. Part 1. Interappointment pain. Journal of Endodontics. 1983;9(9):384–387.
    1. Harrison JW, Baumgartner IC, Zielke DR. Analysis of interappointment pain associated with the combined use of endodontic irrigants and medicaments. Journal of Endodontics. 1981;7(6):272–276.
    1. Oliet S. Single-visit endodontics: a clinical study. Journal of Endodontics. 1983;9(4):147–152.
    1. Marshall JG, Liesinger AW. Factors associated with endodontic posttreatment pain. Journal of Endodontics. 1993;19(11):573–575.
    1. Al-Negrish ARS, Habahbeh R. Flare up rate related to root canal treatment of asymptomatic pulpally necrotic central incisor teeth in patients attending a military hospital. Journal of Dentistry. 2006;34(9):635–640.
    1. Oginni AO, Udoye CI. Endodontic flare-ups: comparison of incidence between single and multiple visit procedures in patients attending a Nigerian teaching hospital. BMC Oral Health. 2004;4, article 4
    1. Figini L, Lodi G, Gorni F, Gagliani M. Single versus multiple visits for endodontic treatment of permanent teeth. Cochrane Database of Systematic Reviews. 2007;(4) Article ID CD005296.
    1. Naito T. Single or multiple visits for endodontic treatment? Evidence-Based Dentistry. 2008;9(1, article 24)
    1. Clem WH. Posttreatment endodontic pain. The Journal of the American Dental Association. 1970;81(5):1166–1170.
    1. Calhoun RL, Landers RR. One-appointment endodontic therapy: a nationwide survey of endodontists. Journal of Endodontics. 1982;8(1):35–40.
    1. Fox J, Atkinson JS, Dinin AP, et al. Incidence of pain following one-visit endodontic treatment. Oral Surgery, Oral Medicine, Oral Pathology. 1970;30(1):123–130.
    1. Udoye CI, Jafarzadeh H. Pain during root canal treatment: an investigation of patient modifying factors. The Journal of Contemporaty Dental Practice. 2011;12(4):301–304.
    1. Albashaireh ZSM, Alnegrish AS. Postobturation pain after single- and multiple-visit endodontic therapy. A prospective study. Journal of Dentistry. 1998;26(3):227–232.
    1. Mattscheck DJ, Law AS, Noblett WC. Retreatment versus initial root canal treatment: factors affecting posttreatment pain. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2001;92(3):321–324.
    1. Iqbal M, Kurtz E, Kohli M. Incidence and factors related to flare-ups in a graduate endodontic programme. International Endodontic Journal. 2009;42(2):99–104.
    1. Alves VDO. Endodontic flare-ups: a prospective study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2010;110(5):e68–e72.
    1. Moskow A, Morse DR, Krasner P, Furst ML. Intracanal use of a corticosteroid solution as an endodontic anodyne. Oral Surgery Oral Medicine and Oral Pathology. 1984;58(5):600–604.
    1. Torabinejad M, Kettering JD, McGraw JC, Cummings RR, Dwyer TG, Tobias TS. Factors associated with endodontic interappointment emergencies of teeth with necrotic pulps. Journal of Endodontics. 1988;14(5):261–266.
    1. Ng YL, Glennon JP, Setchell DJ, Gulabivala K. Prevalence of and factors affecting post-obturation pain in patients undergoing root canal treatment. International Endodontic Journal. 2004;37(6):381–391.
    1. Genet JM, Hart AA, Wesselink PR, Thoden van Velzen SK. Preoperative and operative factors associated with pain after the first endodontic visit. International Endodontic Journal. 1987;20(2):53–64.

Source: PubMed

3
Abonnieren