Effect of Occlusal Adjustment on Postoperative Pain after Root Canal Treatment: A Randomized Clinical Trial

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.

Calcium Silicate-Based Sealers Do Not Reduce the Risk and Intensity of Postoperative Pain after Root Canal Treatment when Compared with Epoxy Resin-Based Sealers: A Systematic Review and Meta-Analysis

“…[3][4][5][6] Pain evolution reaches its maximum peak in 24 hours and begins to decrease after the second day, reaching minimum levels in 7 days. 7 Some factors are studied to understand their relationship with the occurrence and intensity of postoperative pain, such as extrusion of chemical solutions, 8 type of instrumentation, 3,9 dental pulp status, 1 preoperative pain, 10,11 apical extrusion of filling material, 12,13 occlusal adjustment procedures, 6,14 and photobiomodulation therapy, 4,5 or infrared rays therapy to minimize pain occurrence. 15 Obturation techniques that use thermoplasticized gutta-percha have become more frequent because they result in homogeneous fillings and satisfactory sealing against marginal infiltration, 16 but may favor apical extrusion of filling material.…”

“…In recent randomized clinical trials (RCTs), approximately 40 to 80% of patients report same discomfort after endodontic interventions. 3 4 5 6 Pain evolution reaches its maximum peak in 24 hours and begins to decrease after the second day, reaching minimum levels in 7 days. 7 …”

“…Some factors are studied to understand their relationship with the occurrence and intensity of postoperative pain, such as extrusion of chemical solutions, 8 type of instrumentation, 3 9 dental pulp status, 1 preoperative pain, 10 11 apical extrusion of filling material, 12 13 occlusal adjustment procedures, 6 14 and photobiomodulation therapy, 4 5 or infrared rays therapy to minimize pain occurrence. 15 …”