Prevalence, predictive factors and clinical course of persistent pain associated with teeth displaying periapical healing following nonsurgical root canal treatment: a prospective study

Philpott, R. H.; Gulabivala, K; Leeson, Rachel; Ng, YL

doi:10.1111/iej.13029

Cited by 23 publications

(29 citation statements)

References 30 publications

(85 reference statements)

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“…There is therefore a risk that the results overestimate the proportion of patients in the adult population who experience symptoms from their root filled tooth. However, the findings agree with earlier studies reporting on frequency of post-treatment pain from root filled teeth (Polycarpou et al 2005, Nixdorf et al 2010a, Vena et al 2014, Philpott et al 2018.…”

Section: Participationsupporting

confidence: 92%

“…, Philpott et al . ). However, there are no published studies specifically screening for overall frequency of pain associated with root filled teeth in a general population.…”

Section: Introductionmentioning

confidence: 97%

“…In a retrospective study, 45% of patients had experienced painful episodes from a root filled tooth with a persisting endodontic lesion up to 20 years post-treatment (Yu et al 2012). However, persistent pain after RCT may have both odontogenic and nonodontogenic origin (Nixdorf et al 2015, Philpott et al 2018.…”

Section: Introductionmentioning

confidence: 99%

“…The previous reports have usually focused on the frequency of persistent pain after RCT (Nixdorf et al 2010a,b), on pain as an outcome in relation to time since the RCT was performed (Polycarpou et al 2005, Vena et al 2014, and also attempted to identify the cause of such pain (e.g. remaining infection or nonodontogenic pain) (Nixdorf et al 2010b, Philpott et al 2018. However, there are no published studies specifically screening for overall frequency of pain associated with root filled teeth in a general population.…”

Section: Introductionmentioning

confidence: 99%

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The frequency and characteristics of pain and discomfort associated with root filled teeth: a practice‐based study

et al. 2019

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Aim To (i) investigate the frequency and characteristics of pain and discomfort associated with root filled teeth in adult patients regularly attending the Public Dental Service in Örebro County, Sweden; (ii) assess the association between symptoms and clinical and radiographic findings; and (iii) explore the impact of pain and discomfort from root filled teeth on daily life. Methodology Patient records of adult patients (≥20 years) scheduled for routine check‐ups in April 2015 were screened to identify individuals with root filled teeth; all patients with ≥1 root filled tooth were asked to participate. The examination comprised of clinical and radiographic examinations and questionnaires on general health, on pain symptoms from root filled teeth and on the impact of pain on daily activities. In a general estimating equation (GEE), examination findings and patient‐related factors were independently analysed in relation to the outcome ‘presence of pain’. Results In total, 550 patients with 1256 root filled teeth participated. Fifty‐three patients (9.6%) experienced pain or discomfort from 62 (4.9%) root filled teeth. Lower age, percussion tenderness and apical tenderness were significantly associated with pain (P > 0.001 to P = 0.044). The average pain intensity was 2.1 on a (0–10) Numeric Rating Scale, and average duration was 28.4 months. The impact on daily life was low. Conclusions On average, pain associated with root filled teeth was of mild intensity, >2 years of duration and had low impact on daily life. Although the significantly associated clinical findings may indicate apical periodontitis as the most probable explanation in some teeth, the origin of pain from root filled teeth remains partly unexplained.

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Section: Participationsupporting

confidence: 92%

“…, Philpott et al . ). However, there are no published studies specifically screening for overall frequency of pain associated with root filled teeth in a general population.…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The frequency and characteristics of pain and discomfort associated with root filled teeth: a practice‐based study

et al. 2019

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“…This challenge can be overcome with the use of the bite force transducer as an objective diagnostic tool. Notably, several studies have identified predictors for postoperative endodontic pain, including intensity and duration of the preoperative pain and patient sex and age [11][12][13][14] . Although these are strong predictors for postoperative pain, and possibly its transition into chronic odontogenic pain, far little is known about their association with the magnitude of MA, a chief complaint in persistent endodontic pain 11 .…”

Section: Significancementioning

confidence: 99%

Quantitative Assessment of Mechanical Allodynia and Central Sensitization in Endodontic Patients

Alelyani

Azar

Khan

et al. 2020

Journal of Endodontics

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Introduction: Patients seeking endodontic treatment commonly present with reduced mechanical pain thresholds (ie, mechanical allodynia [MA]) in the offending teeth. In patients with moderate to severe pain, MA may manifest in the teeth contralateral to the offending teeth because of the onset of central sensitization (CS). We hypothesize that there are quantitative differences in MA and CS in patients with different pulp and periradicular diagnoses. Methods: Patients (n 5 70) receiving endodontic treatment in the graduate endodontic clinic at the University of Texas Health Science Center at San Antonio and healthy volunteers (n 5 10) were included in this cross-sectional study. The mechanical pain threshold from molar teeth was measured by a digital bite force transducer on the offending tooth (ipsilateral) and the contralateral tooth. Ipsi-and contralateral MA among different endodontic diagnoses were analyzed using the Kruskal-Wallis with Dunn post hoc test and the Student t test for differences between sexes. Multivariate regression models analyzed predictors for MA and CS. Results: Periradicular diagnoses of asymptomatic apical periodontitis, symptomatic apical periodontitis, and chronic apical abscess cases were significantly associated with MA. CS, seen as contralateral MA, was only detected in pulpal diagnosis of symptomatic irreversible pulpitis, previously initiated treatment, symptomatic apical periodontitis, and chronic apical abscess. Females experienced significantly lower pain thresholds than males on both sides. MA and CS were significantly correlated in both sexes. The preoperative pain level and duration were significant predictors for MA and CS only in female patients. Lastly, age was a significant predictor for MA in females. Conclusions: The magnitude of MA and CS varied with different endodontic diagnoses, with CS being correlated with increases in MA. Only in female patients were age, preoperative pain duration, and intensity significant predictors for the development of MA and CS.

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Outcomes of referrals from endodontic to orofacial pain specialists: A retrospective cohort study

Erdoğan

Ramsey

Uyanik

et al. 2021

Clinical & Exp Dental Res

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Objectives: Diagnosis and treatment of non-odontogenic pain is challenging for endodontists. The purpose of the study was to investigate the outcomes of referrals to orofacial pain specialists made for patients with suspected non-odontogenic pain, after evaluation and/or treatment by an endodontist. Materials and Methods:A retrospective review of dental records was conducted for 60 patients referred from a postgraduate endodontic clinic to an orofacial pain clinic.Patient demographics, pain history, endodontic, and orofacial pain diagnoses were collected. Number of visits, length of treatment, and treatments prescribed were recorded. For analysis of outcomes, data pertinent to resolution/persistence of symptoms and patient compliance were analyzed.Results: Thirty-five patients were included in the study. The most frequent pulpal and periapical diagnoses were previously treated (62%) and symptomatic apical periodontitis (72%), respectively. The most common orofacial pain diagnosis was temporomandibular disorder. The average time spent to diagnose and treat the pain was 17 months. Pain reduction varied and was documented for 51% of patients. Indications of non-compliance with orofacial pain appointments and treatments were documented for 66% of patients.Conclusions: Non-odontogenic pain diagnosis and treatment are challenging.Patients may have an increased predilection for developing persistent pain after endodontic treatment and/or have an undiagnosed, chronic orofacial pain condition as a true source of their chief complaint. It may be helpful for endodontists to set expectations of typical treatment times/plans when referring patients for evaluation and treatment of non-odontogenic pain.

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Prevalence, predictive factors and clinical course of persistent pain associated with teeth displaying periapical healing following nonsurgical root canal treatment: a prospective study

Cited by 23 publications

References 30 publications

The frequency and characteristics of pain and discomfort associated with root filled teeth: a practice‐based study

The frequency and characteristics of pain and discomfort associated with root filled teeth: a practice‐based study

Quantitative Assessment of Mechanical Allodynia and Central Sensitization in Endodontic Patients

Outcomes of referrals from endodontic to orofacial pain specialists: A retrospective cohort study

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