Influence of Tooth Factors and Procedural Errors on the Incidence and Severity of Post-Endodontic Pain: A Prospective Clinical Study

Abstract

<jats:p>The objective of this prospective study was to assess tooth-related factors that play a role in the incidence of postoperative pain (PP) and determining if procedural errors influence PP occurrence. A total of 442 patients referred for root canal treatment met the inclusion criteria and were included in this prospective study. The same protocol was used in all root canal treatments. Patient, tooth, treatment related factors and the occurrence of procedural errors were registered. Incidence and intensity of PP was assessed at 24 and 48 h by telephonic interview and in person seven and 15 days after treatment. A logistic and ordinal regression analysis was used to assess the role of patient, tooth and treatment related factors in the incidence and intensity of PP, respectively. Preoperative and intraoperative factors differently affected the incidence of PP at the different time intervals. The presence of procedural errors did not significantly influence PP occurrence. The presence of preoperative pain and the need of additional anesthesia during treatment were associated with higher incidence of PP 24 and 48 h after treatment; the extent of apical enlargement played a significant role in the presence of PP after seven days of treatment; and the excessive occlusal load induced by the absence of a contralateral tooth was the only factor related to the maintenance of PP up to 15 days. In conclusion, the presence of preoperative pain, the need of additional anesthesia during treatment, the extent of apical enlargement and the excessive occlusal load induced by the absence of a contralateral tooth were related to a higher incidence of PP.</jats:p>

Effect of laser assisted local anesthesia in single-visit root canal treatment for mandibular molar teeth with acute irreversible pulpitis

“…Arias et al 2013 ( 16) reported that spontaneously triggered post-operative pain was the most commonly reported type of discomfort, which is in agreement with the current results. Occlusal contact was not relieved in the present study inorder to stimulate the worst-case scenario for evaluating post-operative pain as the presence of occlusal contact has been associated with increased post-treatment discomfort (10, 16). Despite this, the post-operative pain occurrence was similar to other reports on pain following root canal treatment (16), thereby confirming the efficacy of laser application.…”

“…A 10-point VAS was employed as our previous studies with irreversible pulpitis (3, 5, 10, 11) followed this similar protocol, which allowed us to have standardised metrics for efficient patient communication. Additionally, most of the patients encountered in the authors’ department have limited education which would greatly impair their interpretation of a pain scale with more than 10-points.…”

Evaluation of postoperative Pain after endodontic treatment using XP-endo shaper and Oneshape (A double-blind randomized study)

“…Regarding gender there is no agreement in the literature about its role on postoperative pain incidence following endodontic treatment, with certain observations concluding that gender has no influence, the subjective component of the pain experience is probably the reason why gender varies among the different studies 26 . It is controversial between many studies that tested the influence of gender on postoperative pain as there were always variations some proved that males had significantly higher pain scores compared to females 24 , others referred to females having higher postoperative pain levels 27 .…”

“…There is a strong correlation found between preoperative pain and the incidence of postoperative pain 27 , and the presence and severity of preoperative pain has a strong effect on the development of pain after endodontic intervention 6 . Patients with increased preoperative pain have a higher risk of experiencing postoperative pain 26 . The core endodontic literature agreed that endodontic treatment significantly reduces preoperative pain proving that the approach used is effective in treating pain 25 .…”

Comparison of Postoperative Pain Levels after Root Canal Instrumentation with Two Rotary Nickel Titanium Instruments (An In-Vivo Study)

“…One of the goals of endodontic treatment is to decrease the post endodontic pain as well as to preserve the compromised tooth structure to maintain function 1 . Post endodontic pain can be defined as the unpleasant sensation following root canal treatment that is reported in 3%-65% of the cases 2 .…”