Cumulative Factors Determining Endodontic Operative Pain and Persistent Apical Periodontitis Following Nonsurgical Root Canal Treatment in Permanent Teeth - A Comprehensive Literature Review

Abstract

Pain and discomfort experienced during and after endodontic treatment are referred to as endodontic operative pain. The condition is complicated and multifactorial, with preoperative factors relating to the host and the affected tooth, intra-operative factors resulting from mechanical, chemical, or microbial damage to peri-radicular tissues, and postoperative factors (the success of the root canal treatment, the effectiveness of pain management techniques and the persistence of periapical inflammation). The presence of persistent apical periodontitis after unsuccessful non-surgical root canal treatment may need endodontic apical surgery. This comprehensive literature review aims to explore the etiopathogenesis of endodontic operative pain and identify the factors that can influence and aggravate it. By understanding the underlying mechanisms and potential influences, dentists can implement effective strategies to prevent or manage endodontic operative pain more efficiently. Dental practitioners must convey to the patients regarding the root canal treatment process, potential discomfort and available pain management options clearly, alleviating patients' fears and enhancing their compliance with postoperative care instructions.