Influence of Preoperative Mechanical Allodynia on Predicting Postoperative Pain after Root Canal Treatment: A Prospective Clinical Study

Young Eun Jang, Yemi Kim, Bom Sahn Kim

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4 Scopus citations


Introduction: Odontogenic pain can manifest as pulpal pain, periapical pain (mechanical allodynia), or both. This study aimed to assess the changes in the intensity of mechanical allodynia (MA) and to identify predictors of postoperative pain after root canal treatment (RCT). Methods: In total, 579 consecutive patients who required RCT were enrolled; we included patients with asymptomatic pulpal diagnoses to avoid any effects of preoperative spontaneous pain on postoperative pain and to evaluate MA independently. Using a visual analog scale (VAS), patients separately indicated the intensity of spontaneous pain, tenderness to percussion, and pain on biting; these measurements were performed before treatment (preoperative pain), at the beginning of each visit (postpreparation pain), and daily for 1 week after RCT (postobturation pain). For analytical purposes, patients were subdivided into 2 groups based on the intensity of preoperative MA (none to mild [VAS <4] or moderate to severe [VAS ≥4]) to evaluate changes in MA and predictive factors of moderate to severe postoperative pain. A generalized estimating equation, repeated-measures analysis of variance, and logistic regression analysis were used. Results: Although the intensity of MA was significantly higher in the moderate to severe group after the initiation of RCT (P < .05), 93% of them experienced alleviation in MA, and 30% of patients in the none to mild group experienced an increase in MA. After adjusting for clinical variables, moderate to severe preoperative MA and the presence of necrotic pulp were significantly correlated with moderate to severe postoperative pain with an odds ratio of 4.107 and 0.286, respectively. Conclusions: Moderate to severe preoperative MA was a predictive factor of postoperative pain in patients undergoing RCT.

Original languageEnglish
Pages (from-to)770-778.e1
JournalJournal of Endodontics
Issue number5
StatePublished - May 2021

Bibliographical note

Funding Information:
Supported by the National Research Foundation of Korea grant funded by the Korea government (grant No. NRF- 2018R1D1A1B07045394 ).

Publisher Copyright:
© 2021 American Association of Endodontists


  • Mechanical allodynia
  • odontogenic pain
  • periapical pain
  • postoperative pain
  • preoperative pain intensity
  • root canal treatment


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