TY - JOUR
T1 - Influence of Preoperative Mechanical Allodynia on Predicting Postoperative Pain after Root Canal Treatment
T2 - A Prospective Clinical Study
AU - Jang, Young Eun
AU - Kim, Yemi
AU - Kim, Bom Sahn
N1 - 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
PY - 2021/5
Y1 - 2021/5
N2 - 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.
AB - 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.
KW - Mechanical allodynia
KW - odontogenic pain
KW - periapical pain
KW - postoperative pain
KW - preoperative pain intensity
KW - root canal treatment
UR - http://www.scopus.com/inward/record.url?scp=85103315059&partnerID=8YFLogxK
U2 - 10.1016/j.joen.2021.01.004
DO - 10.1016/j.joen.2021.01.004
M3 - Article
C2 - 33516824
AN - SCOPUS:85103315059
SN - 0099-2399
VL - 47
SP - 770-778.e1
JO - Journal of Endodontics
JF - Journal of Endodontics
IS - 5
ER -