Influence of endodontic procedure on postoperative pain: Evidence from systematic reviews

Krunic, Jelena; Mladenović, Irena; Žuža, Aleksandra; Radović, Igor; Stojanović, Nikola

doi:10.2478/bjdm-2019-0022

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…There is a preparation technique called apical patency in which the apical region of the root canal is maintained as free of tissue remnants and debris by insertion of an undersized K file 1mm longer than the working length, without impairing apical constriction [14]. Studies presented that there is no relationship between apical patency and PP [15].…”

Section: Postoperative Pain In Endodonticsmentioning

confidence: 99%

Postoperative Pain in Endodontics

Özdemir¹

2020

OJDOH

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This review aims to evaluate the definition, reason, and management of postoperative pain during and/or after endodontics treatment. Postoperative pain is very common and its prevalence ranges between 3% and 58% of all endodontic patients and they usually evaluate postoperative pain as a skill criterion of the clinician. Postoperative pain is multifactorial and observed as a result of acute periapical inflammation in response to chemical, mechanical, and/or microbial damage of the periapical area during the endodontic treatment. Therefore, patients should always be informed that pain may be experienced after the procedure and clinicians should follow up-recent studies about the factors that may cause pain, and if possible, adapt clinical procedures accordingly.

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Section: Postoperative Pain In Endodonticsmentioning

confidence: 99%

Postoperative Pain in Endodontics

Özdemir¹

2020

OJDOH

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“…There remains a lack of robust information about the influence of individual factors during root canal preparation on postoperative pain (PP), in addition to the influence of patient-and tooth-related factors (Krunić et al, 2019). Numerous factors like the location and type of tooth, number of root canals, pulp vitality status, presence of preoperative pain or acute abscess, destruction of apical bone, high occlusal contacts and other factors of the affected teeth may influence these adverse reactions (Alí et al, 2016;Mohammadi et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of root canal instrumentation for the treatment of apical periodontitis: A systematic review and meta‐analysis

Bürklein

Arias

2022

Int Endodontic J

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BackgroundThe development of endodontic instruments has rapidly advanced, but their impact on endodontic outcome parameters remains unclear.ObjectivesThis systematic review aimed to answer the following PICOT questions: In patients with apical periodontitis (P) what is the effectiveness of root canal instrumentation ([Q1] performed with contemporary techniques [I] in comparison with ‘traditional’ techniques [C]] and ([Q2] performed with contemporary engine‐driven NiTi instruments [I] compared with other types of contemporary engine‐driven NiTi instruments [with different design and/or technology] [C]) in terms of clinical and patient‐related outcomes (O)?MethodsAfter PROSPERO protocol registration, a literature search was conducted using Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Central Register of Controlled Trials. Grey literature and major journal contents were examined. Two independent reviewers performed the study selection, data extraction and appraisal of included studies. A quantitative meta‐analysis was considered, and statistical heterogeneity and overall quality of evidence were assessed.ResultsNine studies were identified showing substantial methodological differences. Five studies addressed PICOT 1 and three PICOT 2, whereas one study aimed both. A random‐effects meta‐analysis model was considered for the outcome ‘radiographic evidence of normal periodontal ligament space or reduction of apical lesion size’ (PICOT 1) based on three studies with 332 evaluable participants and showed that contemporary instrumentation was associated with a more favourable outcome (p = .005) compared with root canal preparation with stainless steel instruments (odds ratio = 2.07 [95%‐confidence interval = 1.25–3.44]) with no evidence of statistical heterogeneity (I2 = 0%) but low quality of evidence.DiscussionAlbeit a few studies fulfilled eligible criteria, no study had a low risk of bias. Compelling evidence indicating significantly different outcome rates using different endodontic instruments when treating teeth with apical periodontitis is lacking.ConclusionsIn terms of healing, the results of the meta‐analysis determined the higher effectiveness of root canal instrumentation performed with contemporary techniques in comparison with conventional stainless steel instruments in patients with apical periodontitis followed for a minimum of 1 year with low quality of evidence. No differences could be demonstrated between preparations with traditional stainless steel and contemporary NiTi instruments for other clinical and patient‐related outcomes.RegistrationPROSPERO (CRD42021274642).

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A systematic review of the impact of apical patency on postoperative pain

Rezvani,

Eghtesad,

Kouchakzadeh

2024

J Shahrekord Univ Med Sci

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Background and aims: Apical patency (AP), a technique in endodontics, involves keeping a small opening in the apical foramen during root canal instrumentation. However, there has been a debate about its effect on postoperative pain. To clarify this issue, this systematic review aimed to study the literature and determine the impact of AP on postoperative pain after endodontic procedures. Methods: A systematic search was conducted across multiple databases, including PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library, up to November 2, 2023. Studies on the relationship between AP and postoperative pain in endodontic treatments were included in this research. Relevant articles were independently screened, and data were extracted based on our study aims. Results: Eleven randomized controlled trial studies met the inclusion criteria. The findings indicated that among the included studies, six demonstrated no differences between the AP and non-AP (NAP) groups in terms of postoperative pain scores. In addition, four studies reported a decrease in operative pain in the AP group compared to the NAP group, and only one study showed that AP increases postoperative pain. However, conflicting evidence was observed in a subset of studies; there were no significant differences between the AP and NAP groups in terms of the postoperative pain scores. Conclusion: Compared with NAP, AP does not intensify the postoperative pain in teeth with vital and necrotic pulp.

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Influence of endodontic procedure on postoperative pain: Evidence from systematic reviews

Cited by 3 publications

References 31 publications

Postoperative Pain in Endodontics

Postoperative Pain in Endodontics

Effectiveness of root canal instrumentation for the treatment of apical periodontitis: A systematic review and meta‐analysis

A systematic review of the impact of apical patency on postoperative pain

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