Predictors, prevention, and management of postoperative pain associated with nonsurgical root canal treatment: A systematic review

Abstract

Postoperative pain after root canal treatment can be reduced by applying recent advances in endodontic techniques and equipment. This systematic review includes current knowledge about pain after nonsurgical root canal treatment, including predictors, related factors, effects of recent advances, and management. A literature search was performed using the PubMed, ScienceDirect, and Cochrane Library databases for articles published between 1990 and 2016. Search keywords included postoperative pain, nonsurgical treatment, single visit, recent advances in endodontics, and management of postoperative pain with endodontic treatment. Only original research studies were included; editorials, reviews, brief notes, conference proceedings, and letters to the editor were excluded. The initial search yielded 4941 articles, which were assessed and filtered using the selection criteria. Sixty-five studies met the inclusion criteria and were included in the review. The findings showed that pain after nonsurgical root canal treatment occurred in 3–69.3% of patients. Microorganisms were identified as the primary contributors to postoperative pain, and there was no significant difference in postoperative pain between single- and multiple-visit treatments. Postoperative pain after root canal treatment ranges from mild to moderate and occurs even after optimally performed procedures. Furthermore, adequate management of postoperative pain is often considered an indicator of clinical excellence. Application of recently developed endodontic techniques and devices will reduce postoperative pain. Furthermore, a flexible, severity-based drug administration plan can be used to control and manage pain after root canal treatment. Application of the current research findings will reduce pain following root canal treatment and improve patient outcomes.

Effect of intracanal cryotherapy on postendodontic pain: a systematic review and meta-analysis of randomized controlled trials

“…These results could be attributed to the criteria applied for inclusion of patients, since the teeth with abscess, necrosis, or failed RCT cases were excluded and aseptic protocol was followed to minimize the possibility of inter-appointment flare-ups [19]. In 2018, Vera et al Therefore, teeth with irreversible pulpitis and apical periodontitis are at a higher risk of developing postoperative pain [34,35]. Intracanal cryotherapy may be more effective in pain relief for apical periodontitis because of the decrease in inflammation and edema in the apical tissues by low-temperature irrigation methods [36].…”

Effect of intra-canal cryotherapy on post-endodontic pain in single-visit RCT: A randomized controlled trial

“…The investigators excluded any cases with endodontic mishaps and sealer puff to ensure no external effects on post-endodontic pain, and they used Zinc Oxide Eugenol sealer; they did not use intra-canal medication to prevent chemical irritation (Siqueira and Barnett, 2004, AlRahabi, 2017).…”

“…The most common factor cause the post-endodontic is remnants of microorganisms (AlRahabi, 2017). Endodontic irrigation, gutta percha, endodontic sealer, and intra = canal medication are all factors that can cause irritation and post-endodontic pain (Siqueira and Barnett, 2004, AlRahabi, 2017). There is no difference between single-visit and multiple-visit RCT on post-endodontic pain (Manfredi et al, 2016, AlRahabi, 2017).…”

Instrumentación rotatoria comparado con instrumentación manual para tratamiento endodóntico en dientes permanentes.

“…Encontramos cinco revisiones sistemáticas (5,6,7,8,9) que incluyeron 15 estudios primarios (10,11,12,13,14,15,1 6,17,18,19,20,21,22,23,24) , de los cuales, 10 corresponden a ensayos aleatorizados (10,11,12,13,14,15,16,17,18,19) . Esta tabla y el resumen en general se basa en estos últimos, dado que los estudios observacionales no aumentaban la certeza de la evidencia existente, ni entregaban información adicional relevante.…”