Postoperative Pain after Root Canal Treatment: A Prospective Cohort Study

M Gotler,B Bar-Gil,M Ashkenazi

doi:10.1155/2012/310467

Abstract

Aim. To evaluate the incidence and severity of postendodontic treatment pain (PEP) subsequent to root canal treatment (RCT) in vital and necrotic pulps and after retreatment. Methodology. A prospective study. Participants were all patients (n = 274) who underwent RCT in teeth with vital pulp, necrotic pulp, or vital pulp that had been treated for symptomatic irreversible pulpitis or who received root canal retreatment, by one clinician, during an eight-month period. Exclusion criteria were swelling, purulence, and antibiotic use during initial treatment. A structured questionnaire accessed age, gender, tooth location, and pulpal diagnosis. Within 24 h of treatment, patients were asked to grade their pain at 6 and 18 hours posttreatment, using a 1–5 point scale. Results. RCT of teeth with vital pulp induced a significantly higher incidence and severity of PEP (63.8%; 2.46 ± 1.4, resp.) than RCT of teeth with necrotic pulp (38.5%; 1.78 ± 1.2, resp.) or of retreated teeth (48.8%; 1.89 ± 1.1, resp.). No statistical relation was found between type of pain (spontaneous or stimulated) and pulp condition. Conclusion. RCT of teeth with vital pulp induced a significantly higher incidence and intensity of PEP compared to teeth with necrotic pulp or retreated teeth.

Highlights

Prevention and management of postendodontic pain (PEP) is an integral part of endodontic treatment
Most studies that investigated the prevalence of postendodontic pain referred to flare-up, which was defined as severe pain and/or swelling after endodontic treatment, requiring an unscheduled appointment and active treatment
This is a prospective study of individuals who underwent root canal treatment (RCT) in teeth with vital pulp, necrotic pulp, or vital pulp that had been treated for symptomatic irreversible pulpitis, or who received retreatment of the root canal, by one endodontic clinician during an eight-month period

Summary

Introduction

Prevention and management of postendodontic pain (PEP) is an integral part of endodontic treatment. Informing patients about expected postendodontic pain (PEP) and prescribing medications to manage it can increase patient confidence in their dentists, increase patients’ pain threshold, and improve their attitude toward future dental treatment [1, 2]. The large range is apparently due, in large part, to differences in definitions of postendodontic pain. Most studies that investigated the prevalence of postendodontic pain referred to flare-up, which was defined as severe pain and/or swelling after endodontic treatment, requiring an unscheduled appointment and active treatment. Patients who experienced pain after endodontic treatment and did not require active treatment were excluded from those studies [6]

Objectives

Methods

Conclusion