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Karataş E, Kahraman ÇY, Akbıyık N. Association between polymorphisms in catechol-O-methyl transferase, opioid receptor Mu 1 and serotonin receptor genes with postoperative pain following root canal treatment. Int Endod J 2021; 54:1016-1025. [PMID: 33559241 DOI: 10.1111/iej.13493] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the effect of single nucleotide polymorphisms in the COMT, OPRM1, 5HT1A, 5HT2A and 5HTR3B genes on the intensity of postoperative pain following root canal treatment. METHODOLOGY Ninety-five patients with mandibular and maxillary molar teeth diagnosed with symptomatic apical periodontitis and a level of preoperative pain greater than 50 on a 100 mm visual analogue scale (VAS) were included. Salivary DNA was collected from the participants and stored in Eppendorf tubes at -80 °C. Preoperative percussion pain values were recorded before the root canal treatment procedures. After completion of root canal treatment, the participants were given instructions to record their postoperative pain intensity levels at 24, 48 and 72 h, 5 days and 1 week after treatment, using the VAS. A second visit for the patients after seven days was planned to record their intensity levels of percussion pain on VAS. The percussion test was performed by tapping on the occlusal surface of the tooth with a blunt instrument. A QIAamp DNA Mini Kit was used to isolate DNA from saliva, and SNP Genotyping Analysis software version 1 was used to analyse the genotypes by calculating FAM and HEX signals. The Kruskal-Wallis and Mann-Whitney U-tests were used to evaluate pain intensity values amongst the genotypes, alleles, haplotypes and allele combinations. Nominal data (gender, intake and tooth number) were analysed using a Chi-square test. Bonferroni correction was performed. Thus, the significance level was set at 1.6% (P = 0.016), 2.5% (P = 0.025) and 1.25% (P = 0.0125) for genotype, allele and haplotype comparisons, respectively. RESULTS There was no significant difference amongst the genotypes and alleles in terms of pre- and postoperative pain intensity. There was no significant difference amongst the haplotypes formed for the COMT gene in terms of pain intensity. Additionally, there was no significant association between the allelic combination formed for 5HT1A + 5HT2A genes and the intensity of postoperative pain. CONCLUSION The findings indicate that none of the evaluated SNPs for COMT, OPRM1, 5HT1A, 5HT2A and 5HTR3B genes were associated with the intensity of postoperative pain.
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Affiliation(s)
- E Karataş
- Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Ç Y Kahraman
- Department of Medical Genetics, Medical Faculty, Atatürk University, Erzurum, Turkey
| | - N Akbıyık
- Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
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Karataş E, Kirici DÖ, Arslan H. Postoperative Pain After the use of Sodium Hypochlorite gel and Solution Forms: A Randomized Clinical Study. Eur Endod J 2021; 6. [PMID: 33531449 PMCID: PMC8056817 DOI: 10.14744/eej.2020.08370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/08/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The present study aimed to compare the effect of sodium hypochlorite (NaOCl) gel and solution forms on postoperative pain level. METHODS Fifty-two patients were divided into two groups according to the root canal irrigation solution. In the NaOCl solution group, the root canals were irrigated with 2 mL of 5.25% NaOCl between each pecking motion. In the NaOCl gel group, 5.25% NaOCl gel was used according to the manufacturer's instructions. The root canal treatments were completed and the participants were given instructions to record postoperative pain levels on 24, 48, and 72 hours and 1 week after treatment using VAS. RESULTS Intergroup analyses revealed that the NaOCl gel group resulted in significantly less postoperative pain than the NaOCl solution group on day 1. CONCLUSION It can be concluded that using NaOCl gel during root canal preparation results in less postoperative on day 1 when compared with the NaOCl solution.
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Affiliation(s)
- Ertuğrul Karataş
- From the Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Damla Özsu Kirici
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Hakan Arslan
- From the Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
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The top risk factors for endodontic flare-up: a Monte Carlo simulation. Clin Oral Investig 2020; 25:3681-3690. [PMID: 33215302 DOI: 10.1007/s00784-020-03692-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 11/10/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to analyze the strength of risk factors related to endodontic flare-ups and rank them in order of their importance MATERIALS AND METHODS: A systematic literature search of PubMed, Cochrane Central Register of Controlled Trials, Scopus, and ISI Web of Knowledge, and grey literature was conducted up to November 2019. One hundred ninety-eight publications were identified. Twelve records fulfilled the eligibility criteria, and eight significant risk factors for flare-up, namely, "Periapical lesion," "multiple-visit treatment," "preoperative pain," "necrotic teeth," "female gender," "retreatment," "percussion pain," and "analgesics," were selected to construct the simulation model. The final data pool was established by the integration of data of common risk factors in the included articles. Monte Carlo method was used to analyze of combined numerical data, for simulation of the risk factor impacts. Ten thousand iterations were generated in the simulation model. RESULTS The results of the simulation revealed that the risk estimates of the factors had varying ranges of influence and probability on the flare-up risk. "Periapical lesion" was found to be the most sensitive risk factor, following by "preoperative pain" which was ranked the second place. The third-ranked risk factor was "multiple-visit treatment." The least sensitive risk factors for endodontic flare-up were "retreatment," "female gender," "necrotic teeth," and "analgesics." CONCLUSIONS The present study provides better comprehension on the importance of risk factors for flare-up based on their risk estimates. CLINICAL RELEVANCE A Monte Carlo simulation was adopted to identify the most influential risk factors for endodontic flare-up with a ranking, which can be used to provide meaningful predictions and further insights into clinicians' perception of flare-up risk.
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Alharthi AA, Aljoudi MH, Almaliki MN, Almalki MA, Sunbul MA. Effect of intra-canal cryotherapy on post-endodontic pain in single-visit RCT: A randomized controlled trial. Saudi Dent J 2019; 31:330-335. [PMID: 31337936 PMCID: PMC6626252 DOI: 10.1016/j.sdentj.2019.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 03/05/2019] [Accepted: 03/07/2019] [Indexed: 11/17/2022] Open
Abstract
AIM To evaluate the effect of cold and room-temperature normal saline as a final irrigation on post-endodontic pain and to compare the post-endodontic pain level between the different protocols. MATERIALS AND METHODS A randomized controlled trial was conducted on 105 patients who underwent RCT and were distributed blindly and randomly into three equal groups (n = 35): Group 1, Cryotherapy group; Group 2, Room- temperature normal saline group; and Group 3, Control group. The patients were asked to fill out the VAS questionnaire and register their post-endodontic pain at 6, 24, and 48 h. One-way analysis of variance (ANOVA) and was used to determine statistical difference (α = 0.05) among the groups. Tuckey's test was used to calculate P-value (α = 0.05) between two each group. RESULTS The highest post-endodontic pain was in Group 3. There was no significance difference between Group 1 and Group 2. CONCLUSION Final flushing of the canal with saline either cold or at room temperature was effective for post-endodontic pain control. This can be promising as an essential step in endodontic treatment to reduce post-endodontic pain. The room-temperature saline as final irrigation showed comparable results to intra-canal cryotherapy.
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Alomaym MAA, Aldohan MFM, Alharbi MJ, Alharbi NA. Single versus Multiple Sitting Endodontic Treatment: Incidence of Postoperative Pain - A Randomized Controlled Trial. J Int Soc Prev Community Dent 2019; 9:172-177. [PMID: 31058068 PMCID: PMC6489520 DOI: 10.4103/jispcd.jispcd_327_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/13/2018] [Indexed: 11/05/2022] Open
Abstract
AIMS AND OBJECTIVES The aim of the study is to assess any considerable differences in the incidence and severity of postobturation pain after single- and multiple-visit root canal treatment. MATERIALS AND METHODS We carried our study on 400 successive patients who needed root canal treatment. They were randomly categorized into two groups of 200 each. First group underwent single-visit treatment and the other group underwent multiple-visit therapy. Visual analog scale was employed to evaluate pain preoperatively and postoperatively at 6, 12, 24, and 48 h after obturation. The Statistical Package for the Social Sciences version 20 was employed for analysis. RESULTS There was a male predominance (235; 60.26%). Of 390 cases, 167 were vital and 223 were nonvital. There was an insignificant difference between the preoperative and postoperative pain levels of vital and nonvital teeth of both the groups at different time intervals. CONCLUSION There was a less incidence of pain in multiple visit group than single-visit one, which was statistically significant.
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Affiliation(s)
- Moayad Ahmed A. Alomaym
- General Practitioner, Ministry of Health, King Fahad Specialist Hospital, Alqassim Region, Saudi Arabia
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Elzaki WM, Ziada HM, Abubakr NH, Ibrahim YE. Gender and arch effects on the use of non-opioid analgesics for post endodontic pain reduction. AUST ENDOD J 2017; 44:215-224. [PMID: 29034602 DOI: 10.1111/aej.12218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This study aimed to evaluate the secondary outcomes of gender and arch and their impact on pain reduction following initial endodontic therapy. 185 medications, including placebo were prepared, and 170 participants completed the trial. Group 1, received a single dose of Paracetamol alone (G-1), Group 2 received combined Ibuprofen/Paracetamol (G-2). Group 3 received combined Mefenamic acid/Paracetamol (G-3), group 4 received combined Diclofenac K/Paracetamol (G-4) and Group 5 received a placebo (G-5). There were no statistically significant differences in pain reduction between males and females whilst there were statistically significant differences between them and the placebo group. All combinations of Paracetamol performed better in pain reduction than the placebo among females, while there were no statistically significant differences among males. In conclusion, there were no differences in pain reduction between males and females, and arch for the tested analgesics taken immediately following initial endodontic therapy in teeth with irreversible pulpitis.
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Affiliation(s)
- Wail M Elzaki
- Faculty of Dentistry, King Khalid University, Abha, Saudi Arabia.,Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Hassan M Ziada
- Department of General Dental Practice, Faculty of Dentistry, Health Sciences Center, Kuwait University, Kuwait, Kuwait
| | - Neamat H Abubakr
- Department of Clinical Dental Science, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Yahia E Ibrahim
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
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Eren B, Onay EO, Ungor M. Assessment of alternative emergency treatments for symptomatic irreversible pulpitis: a randomized clinical trial. Int Endod J 2017; 51 Suppl 3:e227-e237. [DOI: 10.1111/iej.12851] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 08/24/2017] [Indexed: 12/29/2022]
Affiliation(s)
- B. Eren
- Department of Endodontics; Faculty of Dentistry; Baskent University; Ankara Turkey
| | - E. O. Onay
- Department of Endodontics; Faculty of Dentistry; Baskent University; Ankara Turkey
| | - M. Ungor
- Department of Endodontics; Faculty of Dentistry; Baskent University; Ankara Turkey
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Nair M, Rahul J, Devadathan A, Mathew J. Incidence of Endodontic Flare-ups and Its Related Factors: A Retrospective Study. J Int Soc Prev Community Dent 2017; 7:175-179. [PMID: 28852632 PMCID: PMC5558250 DOI: 10.4103/jispcd.jispcd_61_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 06/12/2017] [Indexed: 11/17/2022] Open
Abstract
Aims and Objectives: The aim and objective of the study were to determine the incidence of flare-ups during endodontic treatment and to identify the risk factors associated with flare-ups. Subjects and Methods: A total of 1725 patients who were treated during the time period of 2009–2014 by the same endodontist were reviewed. Incidence of flare-up, patients' age, gender, status of pulp, tooth position, number of roots, and treatment provided were taken from their dental records. Relationship between these factors and flare-ups was examined. Statistical analysis was done using Pearson Chi-square test and Fisher's exact test. Results: A total of 2% incidence of endodontic flare-ups was seen out of 1725 cases. Patient's age, gender, and diagnosis had a significant effect on the development of flare-ups (P < 0.05). Tooth type, position of tooth, number of root canals, number of visits, and treatment modality had no significant effect on flare-up incidence. Conclusions: Diagnosis plays an important role in predicting the incidence of flare-ups. Patients in the age group of 40–60 years had a higher risk of developing flare-ups. Women compared to men are more prone to flare-ups.
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Affiliation(s)
- Manuja Nair
- Department of Conservative Dentistry and Endodontics, Pushpagiri College of Dental Sciences, Pathanamthitta, Kerala, India
| | - J Rahul
- Department of Conservative Dentistry and Endodontics, Pushpagiri College of Dental Sciences, Pathanamthitta, Kerala, India
| | - A Devadathan
- Department of Conservative Dentistry and Endodontics, Pushpagiri College of Dental Sciences, Pathanamthitta, Kerala, India
| | - Josey Mathew
- Department of Conservative Dentistry and Endodontics, Pushpagiri College of Dental Sciences, Pathanamthitta, Kerala, India
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Saumya-Rajesh P, Krithikadatta J, Velmurugan N, Sooriaprakas C. Post-instrumentation pain after the use of either Mtwo or the SAF system: a randomized controlled clinical trial. Int Endod J 2016; 50:750-760. [DOI: 10.1111/iej.12702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 09/19/2016] [Indexed: 12/14/2022]
Affiliation(s)
- P. Saumya-Rajesh
- Department of Conservative Dentistry and Endodontics; Meenakshi Ammal Dental College and Hospital; Meenakshi University; Chennai Tamil Nadu India
| | - J. Krithikadatta
- Department of Conservative Dentistry and Endodontics; Meenakshi Ammal Dental College and Hospital; Meenakshi University; Chennai Tamil Nadu India
| | - N. Velmurugan
- Department of Conservative Dentistry and Endodontics; Meenakshi Ammal Dental College and Hospital; Meenakshi University; Chennai Tamil Nadu India
| | - C. Sooriaprakas
- Department of Conservative Dentistry and Endodontics; Meenakshi Ammal Dental College and Hospital; Meenakshi University; Chennai Tamil Nadu India
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Onay EO, Ungor M, Yazici AC. The evaluation of endodontic flare-ups and their relationship to various risk factors. BMC Oral Health 2015; 15:142. [PMID: 26577095 PMCID: PMC4647657 DOI: 10.1186/s12903-015-0135-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 11/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To 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. METHODS Records 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. RESULTS The 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. CONCLUSIONS The 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.
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Affiliation(s)
- Emel Olga Onay
- Department of Endodontics, Baskent University, School of Dentistry, 82 sok No 26, 06490, Bahcelievler, Ankara, Turkey.
| | - Mete Ungor
- Department of Endodontics, Baskent University, School of Dentistry, 82 sok No 26, 06490, Bahcelievler, Ankara, Turkey.
| | - A Canan Yazici
- Department of Biostatistics, Baskent University, School of Medicine, Ankara, Turkey.
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Wong AWY, Zhang S, Li SKY, Zhu X, Zhang C, Chu CH. Incidence of post-obturation pain after single-visit versus multiple-visit non-surgical endodontic treatments. BMC Oral Health 2015; 15:96. [PMID: 26272704 PMCID: PMC4536791 DOI: 10.1186/s12903-015-0082-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 08/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Post-obturation pain is frustrating to both patients and dentists. Its incidence may change with the use of contemporary endodontic techniques. This randomised clinical trial aims to compare the incidence of post-obturation pain at one and seven days after single-visit and multiple-visit non-surgical endodontic treatments. METHODS Patients who required primary endodontic treatment in the two clinical trial centres in Hong Kong (HK) and in Beijing (PK) were recruited. Three HK dentists and three PK dentists performed endodontic treatments on 567 teeth using the same procedures and materials, either in a single visit or over multiple visits, using either core carrier or cold lateral condensation for obturation. RESULTS The attrition rate was 5.1%, and a total of 538 teeth were evaluated. Among these teeth, 232 (43%) were operated in HK, 275 (51%) were treated in a single visit, and 234 (43%) were treated using core carrier obturation. Logistic regression analysis showed that teeth with apical periodontitis (OR = 0.35, 95% CI = 0.21-0.57, p < 0.01) and less pre-operative pain (OR = 1.10, 95% CI = 1.03-1.18, p < 0.01) had lower incidences of post-obturation pain after one day. The incidences of post-obturation pain after one day for single-visit and multiple-visit treatments were 24.7% (68 of 275) and 33.5% (88 of 263), respectively (p = 0.50). The incidences of post-obturation pain after seven days for single-visit and multiple-visit treatments were 4.0% (11 of 275) and 5.3% (14 of 263), respectively (p = 0.47). CONCLUSIONS There was no significant difference in the incidences of post-obturation pain after one day and seven days with single-visit or multiple-visit endodontic treatments. TRIAL REGISTRATION ChiCTR-IOR-15005989.
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Affiliation(s)
- Amy Wai-Yee Wong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Shinan Zhang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | | | - Xiaofei Zhu
- VIP Dental Service & Geriatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China.
| | - Chengfei Zhang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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