Performing Root Canal Treatment Research Articles

Dental Students’ Self-Confidence Level in Performing Endodontic Treatment in Dentistry Faculty of Rafsanjan University of Medical

Introduction: The students’ self-confidence level is a key factor affecting the success of endodontics learning. This study aimed to determine the confidence level of dental students who performing root canal treatment at Rafsanjan University of Medical Sciences in 2021.
 Materials & Methods: In this cross-sectional study a questionnaire including demographic information, endodontic experience, attitude toward confidence in performing different stages of root canal treatment, and suggestions for improving the quality of endodontic education was distributed among 54 dentistry students from 5th and 6th -year during the last month of the academic semester. Data were analyzed using T-test, Pearson, and ANOVA tests (α = 0.05). 
 Results: According to the results, of 49 dental students, 24.5% reported the first cases of root canal treatment to be tough. The lowest confidence was reported for finding all root canals in teeth with multiple root canals, preparing access cavity and understanding and managing root canal treatment risks. According to the results of chi-square analysis test, the total confidence score between 5th and 6th year students was not significantly different (p value = 0.648). Also, the relationship between general selfconfidence and students' self-confidence level was not seen (p value = 0.372). There was no significant relationship between the Confidence level and age, academic year, the difficulty level of the first endodontic treatment, and number of endodontic treatments (p value > 0.05).
 Conclusion: Students had lower self-confidence finding all the canals in multi-canal teeth, in properly handling the treatment risks, and preparing the access cavity. Endodontics training should also be improved by increasing clinical sessions and using recent advances in endodontics.

Tingkat Keberhasilan Perawatan Saluran Akar Pada Gigi Non Vital di RSGM Universitas Jember Tahun 2016

Teeth with pulp necrosis, whether or not with periapical abnormalities, may be indicated for root canal treatment. Root canal treatment is a treatment carried out with the aim of removing infected dental pulp tissue, necrotic debris, and microorganisms. It aims to make the root canal sterile and can be filled with filling material so that a hermetic density is obtained in the apical area. Root canal treatment consists of three main stages (Triad Endodontics). The endodontic triad consists of preparation, sterilization and root canal filling. These three stages of root canal treatment are very important because not all root canal treatments end with success. The success of root canal treatment can be evaluated after a minimum of six months. Subjective, objective and radiographic examinations need to be conduct for determining the success of the treatment. Root canal treatment is said to be successful if the results of the three examinations are declared good. This type of research is descriptive research. The research method was carried out by subjective, objective and radiographic examination in the study sample who had performed root canal treatment in 2016 that met the criteria of the researcher. The results of the research are included in the table and interpreted with a percentage that is very low to very good. Based on this, it was concluded that the success rate of root canal treatment in non-vital teeth at RSGM University of Jember in 2016 was 54.54% and included in the sufficient category.

Endodontic Rotary Files, What Should an Endodontist Know?

Clinicians should be aware of all the characteristics and capacities of the instruments that are possible to use when conducting a root canal treatment. The wide variety of nickel–titanium (Ni-Ti) rotary systems on the market and the lack of standardisation of this type of instrument makes the choice in each specific case difficult. Therefore, this review is intended to summarize the characteristics that should be taken into account when choosing one instrument over another. It will be essential to know characteristics, of alloy from which the instrument is made. Moreover, the geometry of the instrument will determine its behaviour, being the mass, the one that marks its resistance to a greater extent. The movement performed by the file is another of the fundamental keys to understand rotary instruments. In conclusion, when performing root canal treatment, the characteristics of the instrument and the tooth must be taken into account, and the operator’s own limitations should be known. This paper provides the key points to keep in mind when making this type of treatment.

A survey on the perception of fear among the dental students while performing root canal treatment

Introduction: Root canal treatment is considered a procedure in endodontics that requires more focus and precision.It is a type of endodontic treatment that is mainly used to repair and save a badly injured or infected tooth. Most dental students feel that they are not prepared well enough to carry out the treatment while practising due to the presence of levels of difficulty of the root canal.Due to the gradual increase in the life expectancy among population and desire of individuals in preserving their natural teeth, an increasing demand for these endodontic treatments and are bound to increase in the years ahead. Aim: Gather information from students regarding their perception of fear of performing RCT, how they self‑evaluate their confidence level while performing in patients and difficulties faced by them. Materials and Methods: A questionnaire based survey was conducted to 100 dental students from pre-clinical second years to interns of saveetha dental college.The survey was conducted online and consisted of 15 questions based on the perception of fear among the students while performing RCT in patients after which the survey was summarised and analysed statistically using SPSS version 23.0.

Chemical neurotoxicity to the inferior alveolar nerve—A rare sequela of endodontic treatment

AbstractAimDamage to the inferior alveolar nerve (IAN) during endodontic procedures is a rare complication. However, over‐ instrumentation and over‐filling during root canal treatment can cause injury through direct trauma, pressure or neurotoxicity from intra‐canal irrigants or root canal filling materials, particularly where the roots of mandibular molars or premolars are in close proximity to the IAN. This report describes the clinical presentation and management of a severe chemical injury to the right IAN following the endodontic treatment. We also provide practical considerations to help minimise such complications.MethodsA 27‐year‐old female developed immediate onset numbness and tingling to the right mental region following endodontic treatment of tooth 47. Radiographic examination confirmed widespread extrusion of root canal sealer within the marrow spaces of the right mandibular body extending centrally within the mandibular canal and perforating the lingual cortex.ResultsUrgent surgical exploration and decompression of the right IAN were undertaken, which revealed an avascular and fibrotic nerve with virtually no normal neuronal structure. There was evidence of foreign material both in contact with the epineurium and within the nerve trunk, much of which could not be eliminated. This severe chemical insult to the nerve resulted in irreversible anaesthesia in the right IAN distribution.ConclusionThis case highlights the diligence that is required when performing root canal treatment in high‐risk mandibular molar teeth, particularly in relation to confining materials within the canal space, accurate canal measurements and comprehensive radiographic evaluation both pre‐ and post‐operatively. Urgent specialist referral for the elimination of foreign material is essential to maximise the potential for nerve regeneration.

Evaluation on the perception of final year dental students on their confidence level regarding endodontic treatments: a cross sectional analysis

Endodontics procedures are difficult and complicated that most of the practitioners would encounter. Therefore, dental students should gain their confidence and competent during their training. This research aimed to study the perception of final year students on confidence level regarding endodontic treatments from all public universities and their opinions on the quality of endodontic education. A Google Form was used to disseminate an online questionnaire to all dental students from public universities across Malaysia. The survey included both scaled answer and open-ended questions. 184 responses out of 235 students, were obtained (response rate = 78%). Perception of competence and confidence were significantly greater amongst the students from research-based universities group (P < 0.05). 93.5% (n=179) of participants agree that they were confident to do endodontic procedure on anterior tooth, whilst on posterior tooth, only 75.5% (n=139) were confident. Only 6.5 percent of participants (n = 12) did not feel confident doing root canal treatment on single-rooted teeth, but 76.1 percent (n = 140) did not feel competent performing root canal treatment on multirooted teeth. Over 90% of the students rated the quality and the amount of time spent on endodontic education were adequate at their respective university as ?5 on a Likert scale (1 = inadequate to 10 = adequate). In addition, when they were asked to give the suggestion on how to improve the quality of endodontic education, 10.9% of the students suggested to increase the number of practical session and to do regular discussion regarding endodontic cases. It is vital to improve undergraduate endodontic education in order to raise students' perceptions of their confidence and competence when doing root canal therapy.

Cone-Beam Computed Tomographic Evaluation of Canal Morphology of Mesiobuccal Root of Maxillary Molars in Saudi Subpopulation.

Introduction:The purpose of this study was to analyze the canal configuration of mesiobuccal root (MBR) of the maxillary molars in the Saudi subpopulation using cone-beam computed tomography (CBCT) and to compare if there is any gender and arch variation.Methodology:In this cross-sectional retrospective evaluation study, analysis of CBCT scans of MBRs of 400 maxillary first and second molars was done that has undergone CBCT scanning for diagnostic/treatment purposes in the private clinic of Jeddah, KSA. Statistical analysis was performed using Student's t-test and Chi-square test.Results:Type I, II, and III canal configurations have been reported to be the most common morphologies in the MBR in both first and second molars, with the incidence of 20.25% (81), 17.25% (69), and 17.25% (69), respectively. Type I canals were significantly (P < 0.001) more common in tooth #17 and #27, Type II canals were significantly (P < 0.001) more seen in tooth #26, Type 3 canals were more seen in tooth #27, but there is no statistically significant association. Supplemental canal configurations which were classified by Gulabivala as Type I, Type II, and Type IV were also seen. Furthermore, 93 additional unclassified canal configurations were also found.Conclusion:The data indicate high prevalence of MB2 canals with varying canal configurations. Preoperative CBCT imaging should always be done in tooth-like maxillary molars, to understand the complex configurations and variations and to achieve higher success while performing root canal treatment.

Endo–perio lesions: A dilemma

Endo–perio lesions are a common finding in dental practice. Progression of an endodontic lesion, if allowed leads to periodontal involvement or vice versa. This is a case series of two cases of the endodontic lesion with periodontal involvement that has been treated by performing root canal treatment followed by flap surgery. The tooth was first endodontically treated that was followed by periodontal treatment. Six months postoperatively, there was a significant gain in clinical attachment level. Radiographically, there was a significant amount of bone fill observed.

WORK RELATED MUSCULOSKELETAL NECK PAIN: A NEGLECTED OCCUPATIONAL DISEASE AMONG DENTISTS IN PESHAWAR, PAKISTAN

Objective:To determine the frequency and risk factors of work-related neck pain among dentists working in Public sector Hospitals in Peshawar, Pakistan.Materials and Methods: A cross sectional study was conducted in Khyber College of Density, Lady Reading Hospital and Hayatabad Medical Complex, Peshawar, Pakistan from 23rd September 2018 to23rd February 2019. A total of 150 dentists who were working in public sector hospitals and were willing to participate were included in the study by convenience sampling. The Standardized Nordic Questionnaire (SNQ) was used for data collection. Data was analyzed with SPSS, version 23.Results:The total number of participants in our study were 150. Males were 105(70%) and females were 45(30%).The mean age was 31.4200± 6.1 years. Majority(72.7%,n=109) of dentists were reported to have work related musculoskeletal pain while 41(27.3%) dentists had no such complaints. The commonly affected dentists were trainee medical officers(61.3%,n=92).The frequency of neck pain was more common among dentists who examined more than 15 patients per day(49.3%,74%) and worked 6 days per week(64%,n=96).Dentists performing root canal treatment(70.7%,n=106) were more prone to have neck pain than others.Conclusion:The frequency of musculoskeletal neck pain among the dentists was high. The risk factors were prolong working hours, examining more patients and prolong dental procedures.

Advantages and Disadvantages of Endodontic Management

Introduction: Root canal treatment is a sequence of treating infected pulp of the tooth which is intended to result in elimination of infection and protecting and restoring the tooth from future microbial invasion.&#x0D; Aim: The aim of the present study is to create awareness among outpatients on the advantages and disadvantages in before and after root canal treatment.&#x0D; Materials and Methods: The questionnaire based survey was conducted among 101 patients in Saveetha Dental College and Hospitals. The participants range from 20-56 years above Main objective of performing root canal treatment is to eliminate bacteria from the infected root canal system/ remove the inflamed pulp tissue and close it with biological material. Root canal treatment done well then regardless of the number of visits, will create a favorable environment for healing.&#x0D; Results: The observed results in the present study were depicted in pie charts and results were analysed using SPSS.&#x0D; Conclusion: The recent advances in endodontics technology attract dental material a lot as they complete the root canal treatment in a couple of days periapical tissue undergoes a lot of changes.

Ethnical Anatomical Differences in Mandibular First Permanent Molars between Indian and Saudi Arabian Subpopulations: A Retrospective Cross-sectional Study

The variation in the anatomy of the root canal system has anthropological and demographic significances. The aim of this study was to compare the number of roots, root canals, and internal canal morphology of permanent mandibular first molars between Indian and Saudi Arabian populations. A total of 523 (255 teeth of Indian sample and 268 teeth of Saudi Arabian sample) mandibular first molar (M1) were included for comparative analysis using cone-beam computed tomography images based on the inclusion criteria. The external and internal morphologies were assessed and compared by trained endodontist and the data was recorded. M1 with three roots were found in 3.9% of the Indian population and 6% of the Saudi population. Overall, high prevalence was observed in two roots (95.0%), three canals (70.4%), Vertucci type IV of the mesial root (56.0%), and Vertucci type I of the distal root (76.7%). Comparison between Indian and Saudi Arabian molars revealed significant differences in relation to the number of canals (p <0.001), Vertucci types of the mesial root (p = 0.008), and Vertucci types of the distal root (p <0.001). Differences between genders for the whole sample revealed significant differences in relation to Vertucci types of the distal root (p = 0.025) with a relatively high male prevalence of type I (54.4%) and type IV (57.1%). The predominant parameters of M1 were two roots, three canals, Vertucci type II and IV mesial root configuration, and type I distal root configuration irrespective of both populations. The root canal morphology of Indian and Saudi Arabian populations shares a common trait of Asian origin. The likelihood of predicting the complex system of the root canal with marked preference to ethnic identity would be a clinical benefit for the dentist performing root canal treatment. How to cite this article: Mashyakhy M, Vinothkumar TS, Arthisri AS et al. Ethnical Anatomical Differences in Mandibular First Permanent Molars between Indian and Saudi Arabian Subpopulations: A Retrospective Cross-sectional Study. J Contemp Dent Pract 2021;22(5):484-490.

Perception of Students and House Officers for Restoration of Endodonticaly Treated Anterior Teeth

Background: Teeth in the oral cavity are affected by caries, trauma or fracture which causes pulpal diseases in the teeth. Dentists performed root canal treatment to treat these diseases. Caries fracture or trauma along with root canal treatment can weaken the tooth structure. Tooth structure is lost in root canal treatment. Dehydration after pulpectomy can effect on survival of the tooth. That is why an important intention should be paid to restore endodonticaly treated tooth. Study was performed in Multan Dental College Multan. Methods: Study design was cross sectional survey. The questionnaire was prepared for final year BDS students and house surgeons of Multan Dental College with the three conditions of anterior tooth structure; Condition A= Minimal tooth structure missing(less than 50%), Condition B=50% tooth structure missing, Condition C=maximum tooth structure lost (more than 50%). Data was collected randomly and analyzed and tabulated. Results: In condition A maximum participants (47.5%) preferred tooth colored restoration only. In condition B maximum participants (33%) choose tooth colored crown. In condition C maximum participants (67.5%) choose endopost and tooth colored crown. Conclusion: of study is that choice of material and technique of restoration is important for good results. Different dentists prefer different materials and techniques for restoration. Keywords: Endodonticaly treated tooth (ETT), Composite, Amalgam, Endopost

An investigation into security, self-confidence and gender differences related to undergraduate education in Endodontics.

To analyse responses from dental practitioners (DPs) on how secure they felt as a newly graduated dentist, level of confidence or self-efficacy when performing root canal treatment (RCT), and if undergraduate (UG) education in Endodontics adequately met their needs in a dental practice. An electronic questionnaire was sent to 459 dentists who graduated from the University of Bergen, Bergen, Norway, between 2008 and 2018. The survey consisted of questions with closed-end options and Likert scale (1-5). An open-ended free text option was always provided. A total of 314 (68.4%) DPs answered the questionnaire. Of these, 87 (27.8%) were men and 224 (71.3%) were women. Three respondents did not disclose their gender. As a newly graduated dentist, 37.3% of the respondents felt secure when performing RCT, 30.7% felt indifferent, and 32.0% felt insecure. The majority (72.4%) of respondents were either confident or very confident when performing RCT, 21.3% were indifferent, and 6.3% had little or no confidence. A majority of DPs (84.4%) self-evaluated the quality of their root fillings as good or very good, and 15.2% were indifferent. Only one DP selected 'not good' and none selected 'bad'. There were significant gender differences where male DPs felt more secure than female DPs when performing RCT (P<0.001). A significantly larger number of men were very confident compared to women (P<0.001). A logistic regression analysis using confidence as a dependent variable to predict self-efficacy revealed that DPs who felt secure when performing RCT as a newly graduated dentist had about 8 times more self-efficacy (odds ratio=8.49) than those who were insecure or indifferent. Respondents who rated their quality of root fillings as good or very good had forty times more self-efficacy (odds ratio=40.06) when performing RCT. UG education in endodontics was considered inadequate by 71.3% of the respondents where a significantly larger number of DPs (70%) wanted more clinical training (P<0.05). About half the DPs (47.7%) stated that there was a need for lifelong learning with majority preferring hands-on courses and continuing dental education organized by dental associations. The results of this study suggest that there is a need to promote self-efficacy during UG education in Endodontics. Hands-on training is the preferred form of lifelong learning for DPs.

Assessment of Different Areas of Perforation While Performing RCT

Root perforation is defined as an iatrogenic or pathological communication between the root canal system and the external tooth/root surface. They may be pathologic or iatrogenic in etiology. Iatrogenic perforations during root canal therapy account for a large portion of endodontic failures and may necessitate the need for extraction. Assessing the sites commonly perforated helps anticipate such complications and thereby formulate means to improve the quality of treatment offered. This study aims to assess the different areas of perforation while performing root canal treatment. A retrospective cross-sectional study was conducted using the patient records from the OPD of Saveetha Dental College, Chennai from June 2019 to April 2020, and patients above the age of 18 years who underwent perforation management were selected by non-probability sampling. Data was collected and then subjected to statistical analysis using Statistical Package for Social Science for Windows (version 20.0, SPSS Inc., Chicago Ill., USA). Chi-square test was employed with a level of significance set at p&lt;0.05. It was found that the most common site of perforation was the furcation area (50%), followed by crown perforations (44.1%). There were more males (52.9%) who experienced perforations than females and the most common age group was 35-55 years (50%). There was a significant difference between the site of perforation and tooth involved (p=0.032). There also was a significant difference between the perforation site and the arch involved (p=0.044). The most commonly perforated tooth was found to be mandibular molars.

ROOT CANAL MORPHOLOGY OF MANDIBULAR INCISORS IN PAKISTANI POPULATION USING CBCT

Objective: To find the incidence of two canals, and root canal morphology of mandibular incisors in Pakistani population thus preventing missed canals during endodontic procedures. Materials and Methods: 100 CBCT scans taken in Armed Forces Institute of Dentistry, Rawalpindi, Pakistan were studied to determine the presence of second canal as well as determining the root canal morphology according to Vertucci’s classification, in mandibular incisors. The data was analyzed using SPSS 20.0. Results: Images of 400 mandibular incisors were observed. 73.8% of the incisors had one canal (Vertucci’s Type I) and 26.2% had two canals (Vertucci’s Type II 4%, Type III 20.4% and Type IV 1.7%). Conclusion: Overall, 26.2% incisors had two canals, so the dentists performing root canal treatment of mandibular incisors must be aware of this fact to avoid missed canal. CBCT can be used successfully to determine root canal configurations.

Materials and Techniques used by General Dental Practitioners in Libya during Endodontic Treatment of Permanent Molar Teeth

Aim: To investigate the current trends in routine endodontic treatment of molar teeth performed by Labyan genral dental practitioners (GDPs). Materials and methods: A total of 750 structured questioners enquiring about various aspects of endodontie Treatment were dispersed among GDPs who work in public and private clinics in five major Libyan cities (Tripoli, Benghazi, Sabha, Misrata, Albida).Results: of the 750 questionnaires, 337 completed replies were received. The response rate was 44.9%. Amongst those 88.1% performed endodontic treatment for molar teeth, while 11.9% mentioned that they refe difficult clin cal cases to endodontie specialists. 21.1% of GDPs used rubber dam for isolation About 95.3% used radiograph for working length determination and only 4.7% used apex locater. More than half of participants (58.2 never found MB2 canal in upper molars, and only 2% of them used magnification tools during root canal treatment. The majority of GDPs 190.89.) used sodium hypochlorite as an intra-canal irrigant, while calcium hydroxide was used by 60.5% of GDPs as an intra-canal medicament, followed by formecresol (39.5%. The step-back and crown down preparation techniques were the methods of choice in this study with a percentage of 61.4% and 24.9% respec tively. Hand instruments were used by 64.4% and rotary instruments were used by 35.6% of the GDPs. Cold lat eral condensation was used by 76.6%, while the rest used single cone technique for obturation. Zinc oxide eugenol was used by 73.9%. The majority of the GDPs completed root canal treatment in three visits or even more (85.4%).Conclusions: Majority of Libyan GDPs performed root canal treatment for molar teeth starting with pre-operative radiograph, used variety of endodontic materials and techniques, and implemented new materials and technol ogies when they became obtainable. Yet, most GDPs used step-back technique for canal preparation and lateral condensation for obturation. Few GDP's used rubber dam which highlights the importance of applying policy and regulations for good-quality practice.

Assessment of Dentists’ Referral Patterns to Endodontist in Turkey

Objective: To determine the factors of endodontic referral from general dental practitioners in Turkey. Methods: A questionnaire containing 39 questions was designed to determine the need for referral to endodontists and the factors that influenced the decision to refer a patient to the endodontist. The survey was sent by e-mail to be registered dentists in a database of the Turkish Dental Association, and only unequivocal responses were included in calculating the percentage data. The categorical data were analyzed with a chi-square test, and the results were presented as frequency and percentage. The significance threshold for all tests was set at p&amp;lt;0.05. Results: The response rate was 5.5% (655). The majority (96.8%) of the respondents performed root canal treatment by themselves, and they refer the patient to an endodontist (92.3%) when they encounter a challenging case. Statistical analyses revealed that female general dentists referred more patients to endodontists than males (p&amp;lt;0.05). “Limitations in mouth opening” was the most common referral reason in the patient related factors. “Difficult diagnosis” was the most common referral reason in the teeth and diagnosis-related factors. A statistically negative correlation was found between the professional experience and patient referral (p&amp;lt;0.05). Conclusion: We concluded that many patient- and tooth-related factors influence the endodontic referral of patients. For a successful treatment, a general dentist should make a proper diagnosis and refer to a specialist if necessary.

One visit endodontic on asymtomatic mummificated mandibular molar

Background. The main goal of root canal treatment is the prevention or treatment of apical periodontitis, which leads to the preservation of natural teeth. Traditionally, root canal treatment is carried out in a number of visits, using extra disinfecting agents in addition to irrigant used during cleaning and shaping procedures that primarily aim to reduce or eliminate microorganisms and their byproducts. from the root canal system before it is obtained. Recent advances in Endodontic technology, attracting dental experts and endodontists to perform root canal treatment in one visit. Numerous studies evaluate the effectiveness of single-versus multiple-appointment root canal treatment have been published, which reported no significant differences in effectiveness (healing rates) between these two treatment regimens.Purpose : preservation of the integrity of the molar teeth that have symptomatic complaints by taking proper care with a short visit time. Caset: A 21-year-old woman presents with concern in her lower left tooth, the patient tells that the tooth had been treated before at the dentist when she was a child. On clinical examination there is a composite restoration in occlusal tooth # 36, non vital teeth. On periapical radiology there are radiopaque on pulp chamber and a diffuse radiolucent area in the apical area of tooth # 36, then the diagnosis then determined Previously initiated therapy with asymptomatic apical periodontitis. Case Management : Tooth # 36 treated with one visit root canal treatment, Treatment is continued with fiber post installation and crown, patients no longer complain of pain after treatment. Teeth function normally again. Conclusion: One visit root canal treatment can successfully eliminate patient complaints and restore tooth function.

A review of the Application of Additive Manufacturing in Endodontic access opening using SLM process

3D Printing refers to a class of technology that can automatically construct 3-dimensional physical models from Computer Aided Design (CAD) data. Reduction of product development cycle time is a major concern in industries for achieving competitive advantage. Endodontic dentistry is the dental specialty concerned with the study and treatment of the dental pulp, and generally diagnose tooth pain and perform root canal treatment and other procedures relating to the interior of the tooth. This article, therefore, aims on being an assistive methodology in endodontics by applying 3D printing in order to reduce the strain involved in the tooth restoration process.

Simultaneous Occurrence of Myofascial Pain Referred to Tooth and Endodontic Lesions in Patient with Toothache: A Case Report

Toothache is almost always caused by odontogenic toothache, but diagnosis is more difficult in the case of nonodontogenic toothache. We report a case of simultaneous occurrence of odontogenic and nonodontogenic toothache. This manuscript presents a case report for a 35-year-old woman who visited our Orofacial and Head Pain Clinic with the chief complaint of continuous dull pain in left maxillary molar teeth region. It was concluded to be a case of simultaneous odontogenic toothache and nonodontogenic toothache. It was successfully treated by an endodontist and an orofacial pain specialist. The endodontist performed root canal treatment against odontogenic toothache caused by apical periodontitis using a dental operating microscope. The presence of a trigger point (TP) resulting in tooth pain was inferred. A trigger point injection (TPI) was administered by orofacial pain specialist, and toothache relief was confirmed. Myofascial pain was diagnosed definitively. After confirming that the toothache had resolved at multiple TPIs, a crown prosthesis was placed. Following the application of crown prosthesis, we were concerned but did not find recurrence of toothache from myofascial pain due to increased occlusal force. This case suggests that there is no single cause of chronic pain and that multiple causes must be considered for diagnosis, suggesting the need for treatment by multiple specialists.