The causes of post oprarative pain after endodontic treatment by the use of periapical radiography in a sample of karbalaian patients

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Sameer Hatem Abdul Haleem


Nonsurgical root canal treatment, Post-endodontic pain (PEP), Radiographic, Radiographic assessment, longitudinal study.


Objective: Radiographic evaluation and identification of factors affecting post-endodontic pain (PEP) in patients receiving non-surgical root canal treatment.
Study Design: a longitudinal study. Place and duration of the study: The study was conducted on 375 patients (200 males, 175 females), aged between 15-65 years, who randomly attended Dr. Samir Hatem's private clinic in Karbala between 2014-2019.
Materials And Methods: A full history of the patients was taken and examined clinically and then examined radiographically by CSN X-ray machine and Xpod digital sensor to identify possible factors and to assess the condition of pre-treated teeth, the patients were divided into groups according to age, etiological factors, and onset of pain from the patients' chief complain.
Results: (Table 2) shows the differences in the numbers and percentages of patients in general according to the onset and the causative factors of pain after root canal treatment, and the high percentage of pain in 102/ (27.2%) of the patients was due to excessive stretching of the filling materials (most of these patients suffered from pain automatic by 47.05%). Followed by 78 / (20.8%) treatment failure due to lack of fullness of the root canal (most of them 34.61% had intermittent pain).
Conclusion: Periapical X-ray radiography is a valuable technique for identifying causative factors for postendodontic pain and for evaluating random treatment success and the condition of inwardly treated teeth and periapical tissues. Not all procedural errors can be depicted on radiographs.

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1. Van Wijk AJ, Hoogstraten J. Reducing fear of pain associated with endodontic therapy. International Endodontic Journal. 2006 May;39(5):384-8.
2. Van Wijk AJ, Duyx MP, Hoogstraten J. The effect of written information on pain experience during periodontal probing. Journal of Clinical
Periodontology. 2004 Apr;31(4):273-81.
3. Levin L, Amit A, Ashkenazi M. Post-operative pain and use of analgesic agents following various dental procedures. American Journal of Dentistry. 2006 Aug 1;19(4):245-7.
4. Ashkenazi M, Blumer S, Eli I. Post-operative pain and use of analgesic agents in children following intrasulcular anaesthesia and various operative procedures. British dental journal. 2007 Mar;202(5):E13-.
5. Imura N, Zuolo ML. Factors associated with endodontic flare‐ups: a prospective study. International Endodontic Journal. 1995
6. Ng YL, Glennon JP, Setchell DJ, Gulabivala
7. K. Prevalence of and factors affecting post‐ obturation pain in patients undergoing root canal treatment. International endodontic journal. 2004 Jun;37(6):381-91.
8. Nivethithan T, Raj JD. Endodontic pain-cause and management: A review. International Journal of Pharmaceutical Sciences and Research. 2015 Jul 1;6(7):2723.
9. Harrison JW, Baumgartner JC, Svec TA. Incidence of pain associated with clinical factors during and after root canal therapy. Part 1. Interappointment pain. Journal of endodontics. 1983 Sep 1;9(9):384- 7.
10. Gondim Jr E, Setzer FC, Dos Carmo CB, Kim11. S. Postoperative pain after the application of two different irrigation devices in a prospective
randomized clinical trial. Journal of Endodontics. 2010 Aug 1;36(8):1295-301.
12. Goreva LA, Petrikas A. Postobturation pain associated with endodontic treatment. Stomatologiia. 2004;83(2):14-6.
13. Makeeva IM, Turkina A. Effects of the method of mechanical root canal treatment on emergence of pain after endodontic management. Stomatologiia. 2005;84(5):21-3.
14. Siqueira Jr JF. Microbial causes of endodontic flare‐ups. International endodontic journal. 2003 Jul;36(7):453-63.
15. Tsesis I, Faivishevsky V, Fuss Z, Zukerman O. Flare-ups after endodontic treatment: a metaanalysis of literature. Journal of Endodontics.
2008 Oct 1;34(10):1177-81.
16. Oliet S. Single-visit endodontics: a clinical study.Journal of Endodontics. 1983 Apr 1;9(4):147-52.
17. Oginni AO, Udoye CI. Endodontic flare-ups: comparison of incidence between single and multiple visit procedures in patients attending a
Nigerian teaching hospital. BMC Oral health. 2004 Dec 1;4(1):4.
18. Wolcott J, Ishley D, Kennedy W, Johnson S, Minnich S. Clinical investigation of second mesiobuccal canals in endodontically treated and
retreated maxillary molars. Journal of endodontics. 2002 Jun 1;28(6):477-9.
19. Engström B, Lundberg M. The correlation between positive culture and the prognosis of root canal therapy after pulpectomy. Odontologisk Revy. 1965;16(3):193.
20. Simon S, Machtou P, Tomson P, Adams N, Lumley
21. P. Influence of fractured instruments on the success rate of endodontic treatment. Dental update. 2008 Apr 2;35(3):172-9.
22. Kerekes K, Tronstad L. Long-term results of endodontic treatment performed with a standardized technique. Journal of endodontics. 1979 Mar 1;5(3):83-90.
23. Siqueira Jr JF. Aetiology of root canal treatment failure: why well‐treated teeth can fail. International endodontic journal. 2001 Jan;34(1):1-0.
24. Nicholls E. Treatment of traumatic perforations of the pulp cavity. Oral Surgery, Oral Medicine, Oral Pathology. 1962 May 1;15(5):603-12.
25. Bryan EB, Woollard G, Mitchell WC. Nonsurgical repair of furcal perforations: a literature review. General dentistry. 1999;47(3):274.
26. ZADEH, Firoozeh Abolhasani, et al. Cytotoxicity evaluation of environmentally friendly synthesis Copper/Zinc bimetallic nanoparticles on MCF-7 cancer cells. Rendiconti Lincei. Scienze Fisiche e Naturali, 2022, 1-7.
27. ROHMAH, Martina Kurnia, et al. Modulatory role of dietary curcumin and resveratrol on growth performance, serum immunity responses,
mucus enzymes activity, antioxidant capacity and serum and mucus biochemicals in the common carp, Cyprinus carpio exposed to abamectin. Fish & Shellfish Immunology, 2022, 129: 221-230.
28. ARIF, Anam, et al. The functions and molecular mechanisms of Tribbles homolog 3 (TRIB3) implicated in the pathophysiology of cancer. International Immunopharmacology, 2023, 114: 109581.
29. MARGIANA, Ria, et al. Functions and therapeutic interventions of non-coding RNAs associated with TLR signaling pathway in atherosclerosis. Cellular Signalling, 2022, 100: 110471.
30. H. A. Al-Hchaimi, M. F. Alhamaidah, H. Alkhfaji, M. T. Qasim, A. H. Al-Nussairi and H. S. Abd-Alzahra, "Intraoperative Fluid
Management for Major Neurosurgery: Narrative study," 2022 International Symposium on Multidisciplinary Studies and Innovative Technologies (ISMSIT), 2022, pp. 311-314, doi: 10.1109/ISMSIT56059.2022.9932659.
31. MOHAMMED, Zainab; QASIM, Maytham T. The Relationship between Insulin Resistance and Hypertension in Patient with Hypertensive. HIV
Nursing, 2022, 22.2: 1659–1663-1659–1663.
32. LEI, Zimeng, et al. Detection of abemaciclib, an anti-breast cancer agent, using a new electrochemical DNA biosensor. Frontiers in
Chemistry, 2022, 10.
33. BASHAR, Bashar S., et al. Application of novel Fe3O4/Zn-metal organic framework magnetic nanostructures as an antimicrobial agent and magnetic nanocatalyst in the synthesis of heterocyclic compounds. Frontiers in Chemistry, 2022, 10.
34. Hülsmann M, Hahn W. Complications during root canal irrigation–literature review and case reports. International endodontic journal. 2000 May;33(3):186-93.
35. Wang SH, Chung MP, Cheng JC, Chen CP, Shieh YS. Sodium hypochlorite accidentally extruded beyond the apical foramen. J Med Sci. 2010 Apr 1;30(2):061-5.
36. Trope M. Flare‐up rate of single‐visit endodontics. International endodontic journal. 1991 Jan;24(1):24- 7.
37. Forsberg J. Radiographic reproduction of endodontic “working length” comparing the paralleling and the bisecting-angle techniques.
Oral Surgery, Oral Medicine, Oral Pathology. 1987 Sep 1;64(3):353-60.
38. Walker RT, Brown JE. Chapter 4. Radiography. In: Stock C, Walker R, Gulabivala K, eds. Endodontics, 3rd edn. Philadelphia, PA, USA: Mosby. 2005:77– 92.