Post operative pain in endodontics: A systemic review

Abstract

Post operative pain is an unpleasant situation for both the dentist and the patient. The purpose of this review is to analyze the effect of certain factors like, gender, teeth type, single/multiple visits, and preobturation pain, on the incidence of post endodontic pain. Electronic database were searched in a systematic method according to the preferred reporting items for systematic review and meta analysis guidelines, with specified inclusion criteria to identify randomized clinical trials and exclude case reports and expert case series. Thirty eight articles were identified and included in this review. It was found out that the variables that affect post endodontic pain can be classified into gender, type of teeth, relation with pre-obturation pain, single/multiple visits, medications, instrumentation and obturation techniques and vitality of teeth. The level of evidence ranged from I (1) to V (5) for each variable. The current review suggests that the factors that influenced the post endodontic pain were interrelated and directly interdependent. Within the limitations of this review like insufficient amount of level I, it is evident to support strongly, the influence of the different factors on post endodontic pain. There is a greater need for more number of randomized clinical trials to support the effects.

Effect of Neem (Azadirachta indica) versus 2.5% sodium hypochlorite as root canal irrigants on the intensity of post‐operative pain and the amount of endotoxins in mandibular molars with necrotic pulps: a randomized controlled trial

“…Fifty patients with mandibular molars with necrotic pulps without or with periapical radiolucency smaller than 3 mm were included. It has been reported that mandibular molars have the highest incidence of post‐operative pain and so represent the worst‐case scenario (Sadaf & Ahmad 2014, Shibu 2015, Mostafa et al . 2020).…”

Pain after root canal treatment with different instruments: A systematic review and meta‐analysis

“…Postoperative pain may occur for a variety of reasons, including preparation beyond the apical terminus, incomplete removal of pulp tissue, overextension of root canal filling material, and extrusion of dentinal and pulpal debris into the periapical area (Seltzer & Naidorf, ; Shokraneh et al., ). Several factors such as gender, pulpal and periapical status, preoperative pain, instruments, irrigation and obturation technique may affect postoperative pain (Nagendrababu & Gutmann, ; Ng, Glennon, Setchell, & Gulabivala, ; Shibu, ). The instrumentation used for this procedure has been demonstrated to be an important operator‐dependent factor that affects the incidence and intensity of postoperative pain.…”

Comparison of Post Instrumentation Pain Score in Irreversible Pulpitis with Occlusal Reduction Versus No Occlusal Reduction

“…(P > .05), Other important variables that can affect the post instrumentation pain are age and gender of patients and instrumentation techniques, trauma to pulpal or periradicular tissues by mechanical or chemical way, microbiological factors, and the type of intracanal medicaments. [2][3][4][5][6] In order to control the effect of age, age group of the sample in the present study was limited from 25 to 40 years of age. In order to control the effect of gender on post instrumentation pain, number of males and females in both groups of present were equal.…”

“…These include age and gender of patients, trauma to pulpal or periradicular tissues by mechanical or chemical way, microbiological factors, instrumentation techniques, percussion sensitivity before root canal therapy and the type of intracanal materials. [2][3][4][5][6] Several techniques are in use for controlling pain in root canal therapy. These include use of analgesics preoperatively and corticosteroids use, use of anesthetics and reducing the occlusal surface of tooth.…”