Posttreatment Endodontic Pain
TL;DR: The study indicates that pain reactions seldom occur when a fistula is present, or in maxillary anterior teeth, so factors of prognostic importance in predicting pain are delineated.
Abstract: Various drugs and treatments have been advocated to decrease pain reactions after endodontic treatment. The present study is an attempt to delineate factors of prognostic importance in predicting pain. Frequency of post treatment pain and other factors were recorded. The study indicates that pain reactions seldom occur when a fistula is present, or in maxillary anterior teeth.
Citations
More filters
TL;DR: Some factors, such as age, sex tooth type, presence of preoperative pain, existence of allergies, absence of periapical lesions, sinus tract stomas, retreated cases as well as those receiving prescribed analgesics, had significant effects on the incidence of endodontic interappointment emergencies.
225 citations
TL;DR: In this study pain was evaluated for factors that affect both pain sensation and pain reaction and a significant relationship was found between preoperative and operative and postoperative pain levels.
141 citations
TL;DR: The predictive models showed that the incidence of post-endodontic pain was significantly lower when the treated tooth was not a molar, demonstrated periapical radiolucencies, had no history of previous pain, and had no occlusal contact.
Abstract: Aim To determine the probability of the incidence, intensity, duration and triggering of postendodontic pain, considering factors related to the patient (age, gender, medical evaluation) and to the affected tooth (group, location, number of canals, pulp vitality, preoperative pain, periapical radiolucencies, previous emergency access, presence of occlusal contacts with antagonist).
Methodology A total of 500 one-visit root-canal treatments (RCTs) were performed to patients referred to an endodontist. Shaping of root canals was performed manually with Gates-Glidden drills and K-Flexofiles, and apical patency was maintained with a size 10 file. A 5% NaOCl solution was used for irrigation, and canals were filled with lateral compaction and AH-plus sealer. Independent factors were recorded during the treatment, and characteristics of postendodontic pain (incidence, intensity, type and duration) were later surveyed through questionnaires. Out of the 500 questionnaires, 374 were properly returned and split in two groups for two different statistical purposes: 316 cases were used to adjust the logistic regression models to predict each characteristic of postendodontic pain using predictive factors, and the remaining 58 cases were used to test the validity of each model.
Results The predictive models showed that the incidence of postendodontic pain was significantly lower when the treated tooth was not a molar (p=0.003), demonstrated periapical radiolucencies (p=0.003), there was no history of previous pain (p=0.006) or emergency endodontic treatment (p=0.045) and there was no occlusal contact (p<0.0001). The probability of experiencing moderate or severe pain was higher with increasing age (p=0.09) and in mandibular teeth (p=0.045). The probability of pain lasting more than two days was increased with age (p=0.1) and decreased in males (p=0.007) and when a radiolucent lesion was present in radiograph (p=0.1).
Conclusions Predictive formulae for the incidence, the intensity and the duration of postendodontic pain were generated and validated considering the interrelation of multiple concomitant clinical factors. A predictive model for triggering postendodontic pain could not be established.
138 citations
Cites result from "Posttreatment Endodontic Pain"
...In accordance with other studies (Clem 1970, O’Keefe 1976, Genet et al. 1986), the results of the present study reveal that the incidence of postendodontic pain was higher in teeth with three or more canals, which may be due to the increase of potential periapical pain foci....
[...]
TL;DR: Patients with pulpally necrotic first and second molars showed an advantage for one-visit endodontic treatment at a 95% confidence level compared with two-visits, and patients who had previously received two-Visit treatment for a different pulpally Necrotic molar served as their own control.
131 citations
Cites background from "Posttreatment Endodontic Pain"
...shown to be more prone to flare-up (1)....
[...]
TL;DR: The effect of irrigation on the production of extruded material at the root apex during standard instrumentation was studied with the use of teeth stored in 10% Formalin.
130 citations
References
More filters
Journal Article•
TL;DR: This review covers 106 years of experimental work and finds strong evidence has been presented to direct future therapeutic research to modification of the psychic reaction to the original sensation and Quantitative work with pain is possible and rewarding.
Abstract: This review covers 106 years of experimental work. Hardly an item has been mentioned for which there have not been opposing data to be considered. This fact has required a rather formidable length of presentation of data. Every effort has been made to give opposing views fairly. But where it is possible to do so, conclusions must be drawn if progress is to be made. The reviewer has set down the conclusions he believes are warranted by the data, but references to the text and, in the text, numerous references to original sources are given, so that the reader can consult the basis for the conclusions stated and arrive at better ones if he can.
1) Pain cannot be satisfactorily defined, except as every man defines it introspectively for himself (II).
2) Pain sensations and pain perceptions are identical. Neither represents the "original sensation" alone but represents also an indefinite amount of psychic processing or reaction component (IX).
3) No convincing demonstration has yet been given that the pain threshold is a constant from man to man, or from one time to another in a given man (VIII).
4) More than a score of factors are ssid to produce variations in the pain threshold. Not a single experimental study has controlled even the majority of these factors. Conclusions concerning pain threshold must therefore be tentative (X).
5) "Experimental" pain and "pathological" pain are both composed of "original sensation" and the psychic processing of the original sensation (XII, B). The results of this processing are synonymous with the psychic reaction component (XII). The two components have not yet been satisfactorily separated experimentally (XII, B). Pain from the two origins differs greatly in the quantitative representation of the two components (XII, B). It is essential that these diffrences be taken into account when scientific study of pain or pain relief is undertaken.
6) The experimental pain techniques at present generally employed in man, while useful for some purposes, are probably useless for the appraisal of the analgesic agents (XI, D, E, F). The same techniques in animals have definite usefulness with the powerful narcotics (XI, G), but none apparently with the acetylsalicylic acid class of compounds (XI, F).
7) Assay of analgesic power can be carried on with less than a 10% error when pathological pain is employed in man provided one works in the steep part of the dose response curve (V, B, 2, a, 3).
8) Techniques for the appraisal of side action liability in sick individuals have not yet been satisfactorily developed and established (V, B, 2, g).
9) No dependable relationship has been established between the action of analgesic agents and the experimental pain threshold in man (XI). The record is better for animals but still far from perfect (XI, G). Uncritical acceptance of the view that a dependable relationship exists in man has done much to confuse and mislead work on pain.
10) Analgesic agents appear to exert their principal, if not entire, effect on the "reaction component" rather than on the "original sensation" (XII). This is perhaps at once the most striking and most surprising concept to come out of this long study. If this view can be further substantiated and if it applies also to other subjective reaponses as well as to pain, and this appears to be the case, then acceptance of this concept will require a wide shift in therapeutic planning. Heretofore the goal has been to dull the "original sensation." Strong evidence has been presented to direct future therapeutic research to modification of the psychic reaction to the original sensation. Here is a promising area for further experimental attack.
11) Quantitative work with pain is possible and rewarding. Experience in this area has already as a prototype to guide work with other subjective responses. Quantitative study of the psychological effects of drugs is an urgent need; such work is properly a part of pharmacology. The possibility of accurate quantitative work in this field has been demonstrated; but even so, accomplishments to data constitute no more than a beginning in what promises to be a great development in pharmacology. Successful pursuit of studies in this field is basic to the sound growth of the behavioral sciences.
509 citations
TL;DR: The fallibility of enthusiastic claims for new drugs makes it desirable to recognize those investigations which are likely to yield substantial data and to lead to interpretations that can be ascribed to pharmacodynamic effects rather than to wish, prejudice, coincidence, accident, or error.
Abstract: The fallibility of enthusiastic claims for new drugs makes it desirable to recognize those investigations which are likely to yield substantial data and to lead to interpretations that can be ascribed to pharmacodynamic effects rather than to wish, prejudice, coincidence, accident, or error. Some new drugs, despite statistical validations in reports of their efficacy and safety, do not survive the test of actual use or, even worse, have serious repercussions. The undesirable effects of such drugs employed therapeutically already have achieved alarming proportions, being observed in approximately 5% of 1,000 consecutive recent admissions to a major hospital in the city of New York.1This situation may become even worse if the present rate of development of new drugs continues (about 550 new preparations each year or more than one every day2) and if the medical profession continues to be misled by poorly conducted or inadequate evaluations of new
83 citations
TL;DR: The clinical effects of sulfathiazole on the relief of the pain felt by patients after initial conventional endodontic therapy had been carried out were investigated.
Abstract: In this double-blind study, the clinical effects of sulfathiazole on the relief of the pain felt by patients after initial conventional endodontic therapy had been carried out were investigated.
19 citations
Journal Article•
14 citations