The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 22 , ISSUE 1 ( January, 2021 ) > List of Articles


Postoperative Pain in Endodontically Treated Teeth: A Cross-sectional Study of Retrospective Data

Bárbara S Fornari, Caroline Solda, Lilian Rigo

Keywords : Dental pulp, Dental pulp necrosis, Edema, Endodontics, Pain

Citation Information : Fornari BS, Solda C, Rigo L. Postoperative Pain in Endodontically Treated Teeth: A Cross-sectional Study of Retrospective Data. J Contemp Dent Pract 2021; 22 (1):42-46.

DOI: 10.5005/jp-journals-10024-3021

License: CC BY-NC 4.0

Published Online: 19-04-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Aim: This study aimed to assess the occurrence of postoperative pain and associated factors in patients treated endodontically at a Postgraduate Center in Endodontics in Southern Brazil. Materials and methods: The evaluation was performed using the medical records of 658 patients. Pulp conditions, postoperative pain, pain intensity, edema, number of sessions (single or multiple), and medication administration in the postoperative period were analyzed. For data analysis, descriptive analyses and univariate and multiple regressions were performed. In the multiple analyses, odds ratios (OR) and their respective 95% confidence intervals were estimated, crude and adjusted for exposure variables in a binary logistic regression model (p-value < 0.05). Results: To perform the adjusted logistic regression, all variables associated with p-value <0.10: gender, edema, and pulp condition (bio- and necropulpectomy) entered the crude model. After the multivariate analysis, a statistically significant association was found between the outcome variable of the presence of postoperative pain and the independent variable of pulp condition, and the presence of pain was associated with patients who underwent endodontics on teeth with live pulp and edema with greater chances of postoperative pain. Conclusion: It was concluded that the pulp condition and edema affected postoperative pain. Clinical significance: The occurrence of postoperative pain was around 30% in both single and multiple sessions, and it was considered relevant for the dental clinic. Pulp condition affected postoperative pain, and the presence of pain was associated with patients who underwent endodontics on teeth with live pulp.

  1. Hameed AHE, Elmubarak BDS, Abu-bakr HN, et al. Postoperative pain in multiple-visit and single-visit root canal treatment. J Endod 2010;36(1):36-39. DOI: 10.1016/j.joen.2009.09.003.
  2. Hepsenoglu Y, Eyuboglu TF, Ozcan M. Postoperative pain intensity after single- versus two-visit nonsurgical endodontic retreatment: a randomized clinical trial. J Endod 2018;44(9):1339–1346. DOI: 10.1016/j.joen.2018.05.017.
  3. Pinheiro MLP, Lopes-Rocha R, Andrade ED. Periapical injection of betamethasone to control postoperative pain in emergency endodontic care - a randomized double blind clinical trial. Braz J Oral Sci 2017;15(3):209–214. DOI: 10.20396/bjos.v15i3.8649983
  4. Ince B, Ercan E, Dalli M, et al. Incidence of postoperative pain after single- and multi-visit endodontic treatment in teeth with vital and non-vital pulp. Eur J Dent 2009;3(4):273–279. PMID: 19826598, PMCID: PMC2761157.
  5. Abusrewil S, Alshanta OA, Albashaireh K, et al. Detection, treatment and prevention of endodontic biofilm infections: what's new in 2020? Crit Rev Microbiol 2020;46(2):194–212. DOI: 10.1080/1040841X.2020.1739622.
  6. Silva EJ, Sa L, Belladonna FG, et al. Reciprocating versus rotary systems for root filling removal: assessment of the apically extruded material. J Endod 2014;40:2077–2080. DOI: 10.1016/j.joen.2014. 09.009.
  7. Kherlakian D, Cunha RS, Ehrhardt IC, et al. Comparison of the incidence of postoperative pain after using 2 reciprocating systems and a continuous rotary system: a prospective randomized clinical trial. J Endod 2016; 42(2):171–176. DOI: 10.1016/j.joen.2015. 10.011.
  8. Tavares SG, Fontana CE, Martin AS, et al. In vivo evaluation of painful symptomatology after endodontic treatment performed using two different irrigation needle insertion depths. Eur J Dent 2020;14(2):274–280. DOI: 10.1055/s-0040-1709930.
  9. Mostafa MEHAA, El-Shrief YAI, Anous WIO, et al. Postoperative pain following endodontic irrigation using 1.3% versus 5.25% sodium hypochlorite in mandibular molars with necrotic pulps: a randomized double-blind clinical trial. Int Endod J 2020;53(2):154–166. DOI: 10.1111/iej.13222.
  10. Segura-Egea JJ, Cisneros-Cabello R, Llamas-Carreras JM, et al. Pain associated with root canal treatment. Int Endod J 2009;42(7):614–620. DOI: 10.1111/j.1365-2591.2009.01562.x.
  11. Kirchhoff AL, Fariniuk LF, Mello I. Apical extrusion of debris in flat-oval root canals after using different instrumentation systems. J Endod 2015;41(2):237–241. DOI: 10.1016/j.joen.2014.09.023.
  12. Bürklein S, Benten S, Schäfer E. Quantitative evaluation of apically extruded debris with different single-file systems: Reciproc, F360 and OneShape versus Mtwo. Int Endod J 2014;47(5):405–409. DOI: 10.1111/iej.12161.
  13. Onay EO, Ungor M, Yazici AC. The evaluation of endodontic flare-ups and their relationship to various risk factors. BMC Oral Health 2015;15(1):142. DOI: 10.1186/s12903-015-0135-2.
  14. Baker NE, Liewehr FR, Buxton TB, et al. Antibacterial efficacy of calcium hydroxide, iodine potassium iodide, betadine, and betadine scrub with and without surfactant against E faecalis in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98(3):359–364. DOI: 10.1016/j.tripleo.2004.04.023.
  15. Direnzo A, Gresla T, Johnson BR, et al. Postoperative pain after 1- and 2-visit root canal therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93(5):605–610. DOI: 10.1067/moe.2002.121900.
  16. Rigo L, Petrini I, Lodi, L. Postoperative pain in endodontic treatment in one session or multiple. Int J Dent 2012;11(1):29–37.
  17. Iqbal M, Kurtz E, Kohli M. Incidence and factors related to flare-ups in a graduate endodontic programme. Int Endod J 2008;42(10):99–104. DOI: 10.1111/j.1365-2591.2008.01461.x.
  18. Yaylali IE, Demirci GK, Kurnaz S, et al. Does maintaining apical patency during instrumentation increase postoperative pain or flare-up rate after nonsurgical root canal treatment? A systematic review of randomized controlled trials. J Endod 2018;44(8):1228–1236. DOI: 10.1016/j.joen.2018.05.002.
  19. Abdulrab S, Rodrigues JC, Al-Maweri SA, et al. Effect of apical patency on postoperative pain: a meta-analysis. J Endod 2018;44(10):1467–1473. DOI: 10.1016/j.joen.2018.07.011.
  20. Almeida G, Marques E, De Martin AS, et al. Influence of irrigating solution on postoperative pain following single-visit endodontic treatment: randomized clinical trial. JCDA 2012;78(84):1–6. PMID: 22985896.
  21. Gambarini G, Testarelli L, De Luca M, et al. The influence of three different instrumentation techniques on the incidence of postoperative pain after endodontic treatment. Ann Stomatol 2013;4(1):152–155. DOI: 10.11138/ads.0152.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.