Abstract
The aim of this prospective, randomized, clinical study was to analyze the influence of occlusal adjustment on the prevalence of postoperative pain after endodontic treatment. Seventy-eight patients, diagnosed with symptomatic irreversible pulpitis with indication for endodontic treatment, were selected to participate in the study. The participants were randomized and divided into two groups: in the occlusal adjustment group (OAG), endodontic treatment was performed with subsequent occlusal adjustment. In the control group (CG), endodontic treatment was performed without occlusal adjustment. Treatments were performed by the same operator. Pain occurrence and intensity were recorded on two scales: the verbal rating scale (VRS) and numerical rating scale (NRS). Pain assessment was carried out by a second examiner, blinded to the experiment, 6, 24 and 72 h after endodontic treatment. Data were analyzed using Mann-Whitney, chi-squared, and Fisher's exact tests. In the occlusal adjustment group, 71.1% reported postoperative pain and 67.5% reported pain in the control group. At the 6-hour assessment, 21 individuals reported pain in the occlusal adjustment group and 24 in the control group (p=0.672). At the 24-hour assessment, 18 and 19 individuals reported pain (p=0.991) and at the 72-hour assessment, 8 and 4 reported pain (p=0.219), respectively. Occlusal adjustment did not influence the prevalence of postoperative pain of endodontically treated teeth with symptomatic irreversible pulpitis.
Highlights
The occurrence of postoperative pain is not a rare outcome after endodontic treatment
The cause of pain after endodontic treatment is multifactorial, which could be related to the procedures, instruments, medication, and substances used before, during, or after biomechanical preparation of the root canal system, as well as aspects related to the pulp or periapical pathology, which can play an important role in the development of postoperative pain [1,3,10,11,12,13]
It was postulated that aggression to the periapical tissues, originating from pulp pathology or endodontic treatment, would result in the release of chemical mediators, agreement with the results found by Jostes and Holland sensitization of voltage-regulated sodium channel molecules and nociceptors, causing a change in the response pattern, among them mechanical allodynia, which is caused by non-painful stimuli
Summary
The occurrence of postoperative pain is not a rare outcome after endodontic treatment. Given the high frequency of postoperative pain, several studies have been carried out in an endeavour to seek treatments using different techniques, substances, instrumentation protocols, and photobiomodulation therapy to minimize pain occurrence [1,2,3,4,5]. Several aspects require elucidation; among them the role of occlusal adjustment after endodontic treatment [6,7,8,9]. The cause of pain after endodontic treatment is multifactorial, which could be related to the procedures, instruments, medication, and substances used before, during, or after biomechanical preparation of the root canal system, as well as aspects related to the pulp or periapical pathology, which can play an important role in the development of postoperative pain [1,3,10,11,12,13]
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