OUTLINING THE CAUSES OF PERSISTENT POST-TREATMENT PAIN IN ENDODONTICS
DDS, MSc, PhD
Assistant Professor Department of Endodontics School of Dentistry Estacio de Sä University Rio de Janeiro, RJ, Grazil.
MSс
Department of Endodontics, Faculty of Dentistry. Estacio de SA University. Rio de Janeiro, RJ, Brazil.
LD
Department of Endodontics, Faculty of Dentistry. Estacio de SA University. Rio de Janeiro, RJ, Brazil.
PhD
Department of Endodontics, Faculty of Dentistry. Estacio de SA University. Rio de Janeiro, RJ, Brazil.
Department of Endodontics, Faculty of Dentistry, Estacio de Sa University, Petropolis, Brasil.
more by this authorChronic pain that arises or persists after endodontic treatment is an undesirable condition that requires proper diagnosis in order to be adequately approached. Some so-called 'mysterious' cases are usually related to limited knowledge or clinical inexperience, but inadequacies of diagnostic tools can also lead to misdiagnosis and confusion. The main causes of chronic post-treatment pain not always promptly recognised are outlined in this paper and include: i) persistent/secondary intraradicular infection; ii) persistent inflammation-undetected lesion; Hi) unnoticed overfilling; iv) missed canals; v) vertical root fracture or crack; vi) wrong tooth; vii) non-odontogenic pain; and viii) central sensitisation (risk factors: preoperative pain, previous painful treatment). By having all of these possible causes in mind, clinicians may create a checklist for the possible reason(s) for pain in difficult individual cases and act proactively to offer the best therapeutic solution.