Predicting intraoperative pain in emergency endodontic patients: clinical study

Abstract

This prospective observational study sought to investigate the incidence of intraoperative pain (IOP) among emergency endodontic patients and to construct an IOP prediction model that includes preoperative pain level (PPL). All patients who underwent emergency endodontic treatment at Gazi University, Ankara, Turkey, during the spring term of 2016 were considered for inclusion in the study. Demographic and clinical variables and PPL were recorded. Local anesthesia was provided to all patients before beginning routine endodontic treatment. IOP was defined as the condition of requiring supplementary anesthesia before the working length was established and exhibiting persistent moderate or severe pain despite supplementary anesthesia. Data from 85% and 15% of 435 patients (178 men, 257 women; mean age: 35 years) were used to develop predictive models by multiple logistic regression analysis and to test external validity of the models, respectively. Two multiple logistic regression models achieved good model fits. Model 1 included age, pulpal diagnosis, and arc (p < 0.05). In addition to these variables, Model 2 included periapical diagnosis and PPL (p < 0.15). Models 1 and 2 showed accuracies of 0.76 and 0.75, sensitivities of 0.74 and 0.77, and specificities of 0.76 and 0.74, respectively for the modeling data (internal validity), and accuracies of 0.82 and 0.80, sensitivities of 0.83 and 0.67, and specificities of 0.81 and 0.81, respectively for the control data (external validity). The IOP incidence was 10.3%. IOP in patients undergoing emergency endodontic treatment can be successfully predicted by using models that account for demographic and clinical variables, including PPL.

Association between dental anxiety and intraoperative pain during root canal treatment: a cross‐sectional study

“…Assessment of the intraoperative pain experienced during root canal treatment was carried out using a visual analogue scale (VAS), allowing the patient to make an overall assessment of their pain, having been used successfully for the clinical assessment of pain, including dental pain (Kayaoglu et al , Yücel et al ). VAS is a valid and reliable method widely used in the endodontic literature (Hargreaves & Keiser , Sathorn et al , Segura‐Egea et al , Martín‐González et al , Alonso‐Ezpeleta et al ).…”

“…Evaluation of dental anxiety is important for two reasons: first, to help the clinician during the management of patients with anxiety (Yücel et al ) and second, to provide evidence‐based research with information on this psychological aspect that often prevents dental treatments (Humphris et al , Kayaoglu et al ).…”

Inferior alveolar nerve block success of 2% mepivacaine versus 4% articaine in patients with symptomatic irreversible pulpitis in mandibular molars: A randomized double‐blind single‐centre clinical trial

“…Pain management during endodontic treatment is crucial for both the patient and the dentist; inadequate pain control could pre‐dispose to fear and anxiety, and consequently avoidance of treatment (Murillo‐Benítez et al, 2020). Symptomatic patients are more likely to experience local anaesthetic failure during treatment and postoperative pain, especially in mandibular molars (Aggarwal et al, 2015; Hargreaves & Keiser, 2002; Weitz et al, 2021; Yücel et al, 2018). The inferior alveolar nerve block (IANB) is the most common technique used for anaesthetising mandibular molars (Zanjir et al, 2019), yet its failure rate could range from 30% to 90% (Aggarwal et al, 2015; Hargreaves & Keiser, 2002; Potočnik & Bajrović, 1999; Zanjir et al, 2019); every effort to attain pain‐free treatment is, thus, important.…”

Translation and Validation of Italian Version of Index of Dental Anxiety and Fear (IDAF-4C+): A Cross-Sectional Study

“…Therefore, assessment of DA is a part of the clinical evaluation of the patient’s condition. Knowing the magnitudes of DA may enhance the patient’s management [ 29 ], reduce activities that can induce the patient’s DA, and help clinicians plan an optimal approach in the most invasive procedures [ 30 , 31 ].…”