The evaluation of endodontic flare-ups and their relationship to various risk factors

Abstract

BackgroundTo evaluate the incidence of flare-ups and identify the risk factors including age, gender, tooth type, number of root canals, initial diagnosis, the type of irrigation regimen, treatment modality and the number of visits, in patients who received root canal treatment from January 2002 to January 2008.MethodsRecords of 1819 teeth belonging to 1410 patients treated by 1 endodontics specialist during 6-year period were kept. Patient, tooth, and treatment characteristics were evaluated and the relationships between these characteristics and flare-ups were studied. Statistical analysis was carried out by using Pearson Chi-square test, Fisher’s Exact test, and Binary Logistic regression analyses.ResultsThe incidence of flare-ups was 59 (3.2 %) out of 1819 teeth that received endodontic therapy. Pulpal necrosis without periapical pathosis was the most common indication for flare-up (6 %) (p < 0.01). Teeth undergoing multiple visits had a higher risk of developing flare-ups compared to those with single appointments (OR: 3.14, CI: 1.414–7.009, p < 0.01). There were also no statistically significant differences in the incidence of flare-ups regarding to age, gender, tooth type, number of root canals, treatment modality, and the irrigation solutions that used during the treatment.ConclusionsThe incidence of flare-up is minimal when teeth are treated in one visit. Absence of a periapical lesion in necrotic teeth is a significant risk factor for flare-ups.

Evaluation of Post-operative Pain after Irrigation Using End-Vented NaviTip Tips versus Side-Vented NaviTip Tips in Teeth with Irreversible Pulpitis: A Randomized Clinical Trial.

“…(Figure 2) Discussion:-Development of post-operative pain after root canal treatment is a common finding. Several risk factors such as gender and age, number of visits, type of intracanal medication used, presence of pre-operative pain, pulpal and periradicular diagnosis and apical extrusion of debris have been correlated with the occurrence of flare-ups (10) . Teeth with irreversible pulpitis were selected in this study to reduce the risk of exacerbation by residual microorganisms found in teeth with necrotic pulp, teeth with apical periodontitis or re-treatment cases (10) .…”

“…Pain was categorized into four categorical scores: none, mild [1][2][3], moderate [4][5][6], severe [7][8][9][10]. Secondary outcomes measured were theplacebo intake incidence, analgesic intake incidence and number of analgesic pills needed at each time point as recorded by the patient.…”

Evaluation of Post-Operative Pain After Irrigation Using End-Vented Navitip Tips Versus Side-Vented Navitip Tips in Teeth With Irreversible Pulpitis: A Randomized Clinical Trial Part Vi.

“…Several risk factors such as gender and age, number of visits, type of intracanal medication used, presence of pre-operative pain, pulpal and periradicular diagnosis and apical extrusion of debris have been correlated with the occurrence of flare-ups (10) .…”

“…Teeth with irreversible pulpitis were selected in this study to reduce the risk of exacerbation by residual microorganisms found in teeth with necrotic pulp, teeth with apical periodontitis or re-treatment cases (10) . Moreover, mandibular posterior teeth were selected due to higher incidence of pain in comparison with maxillary anterior teeth because of the mandibular dense trabecular pattern, that reduces the blood flow and causes localization of infection and exudates leading to delayed healing patterns (11) .…”

“…Pain was categorized into four categorical scores: none, mild [1][2][3], moderate [4][5][6], severe [7][8][9][10]. Secondary outcomes measured were the placebo intake incidence, analgesic intake incidence and number of analgesic pills needed at each time point as recorded by the patient.…”