Journal of Endodontics
Volume 36, Issue 2 , Pages 224-230 , February 2010

Frequency of Persistent Tooth Pain after Root Canal Therapy: A Systematic Review and Meta-Analysis

  • Donald R. Nixdorf, DDS, MS

      Affiliations

    • Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, MN
    • Department of Neurology, Medical School, University of Minnesota, Minneapolis, MN
    • Corresponding Author InformationAddress requests for reprints to Dr Donald Nixdorf, University of Minnesota, 6-320 Moos Tower, 515 Delaware Street SE, Minneapolis, MN 55455.
    • ,
  • Estephan J. Moana-Filho, DDS

      Affiliations

    • Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, MN
    • Center for Neurosensory Disorders, School of Dentistry, University of North Carolina, Chapel Hill, NC
    • ,
  • Alan S. Law, DDS, PhD

      Affiliations

    • Private Practice, The Dental Specialists, Lake Elmo, MN
    • ,
  • Lisa A. McGuire, MLIS

      Affiliations

    • Bio-Medical Library, University of Minnesota, Minneapolis, MN
    • ,
  • James S. Hodges, PhD

      Affiliations

    • Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
    • ,
  • Mike T. John, DDS, MPH, PhD

      Affiliations

    • Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, MN
    • Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN

References 

  1. de Oliveira BH, Nadanovsky P. The impact of oral pain on quality of life during pregnancy in low-income Brazilian women. J Orofac Pain. 2006;20:297–305
  2. Luo Y, McMillan AS, Wong MCM, et al. Orofacial pain conditions and impact on quality of life in community-dwelling elderly people in Hong Kong. J Orofac Pain. 2007;21:63–71
  3. Cohen LA, Harris SL, Bonito AJ, et al. Coping with toothache pain: a qualitative study of low-income persons and minorities. J Public Health Dent. 2007;67:28–35
  4. Woolfolk MW, Lang WP, Borgnakke WS, et al. Determining dental checkup frequency. J Am Dent Assoc. 1999;130:715–723
  5. Anderson R, Thomas DW. ‘Toothache stories’: a qualitative investigation of why and how people seek emergency dental care. Community Dent Health. 2003;20:106–111
  6. Gilbert GH, Shelton BJ, Chavers LS, et al. The paradox of dental need in a population-based study of dentate adults. Med Care. 2003;41:119–134
  7. Locker D. Psychosocial consequences of dental fear and anxiety. Community Dent Oral Epidemiol. 2003;31:144–151
  8. Armfield JM, Stewart JF, Spencer AJ. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health. 2007;7:1
  9. Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science. 2000;288:1765–1769
  10. Macrae WA. Chronic post-surgical pain: 10 years on. Br J Anaesth. 2008;101:77–86
  11. Strindberg LZ. The dependence of the results of pulp therapy on certain factors: an analytic study based on radiographic and clinical follow-up examinations. Acta Odontol Scand Suppl. 1956;14:1–175
  12. Rud J, Andreasen JO, Moller Jensen JE. A follow-up study of 1,000 cases treated by endodontic surgery. Int J Oral Surg. 1972;1:215–228
  13. Orstavik D, Qvist VSK. A multivariate analysis of the outcome of endodontic treatment. Eur J Oral Sci. 2004;112:224–230
  14. Hoskinson SE, Ng Y, Hoskinson AE, et al. A retrospective comparison of outcome of root canal treatment using two different protocols. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:705–715
  15. Kojima K, Inamoto K, Nagamatsu K, et al. Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97:95–99
  16. Imura N, Pinheiro ET, Gomes BP, et al. The outcome of endodontic treatment: a retrospective study of 2000 cases performed by a specialist. J Endod. 2007;33:1278–1282
  17. Ng YL, Mann V, Rahbaran S, et al. Outcome of primary root canal treatment: systematic review of the literature—part 1. Effects of study characteristics on probability of success. Int Endod J. 2007;40:921–939
  18. Doyle SD, Hodges JS, Pesun IJ, et al. Retrospective cross sectional comparison of initial nonsurgical endodontic treatment and single-tooth implants. J Endod. 2006;32:822–827
  19. Perkins FM, Kehlet H. Chronic pain as an outcome of surgery. Anesthesiology. 2000;93:1123–1133
  20. Jones JA, Boehmer U, Berlowitz DR, et al. Tooth retention as an indicator of quality dental care: development of a risk adjustment model. Med Care. 2003;41:937–949
  21. Hujoel PP. Endpoints on periodontal trials: the need for an evidence-based research approach. Periodontol 2000. 2004;36:196–204
  22. Cummings SR, Grady D, Hulley SB. Designing a randomized blinded trial. In:  Hulley SB,  Cummings SR,  Browner WS, et al. editor. Designing clinical research. 3rd ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2007;p. 147–161
  23. Friedman LM, Furberg CD, DeMets DL. Assessing and reporting adverse effects. In:  Friedman LM,  Furberg CD,  DeMets DL editor. Fundamentals of clinical trials. 3rd ed. New York, NY: Springer-Verlag; 1998;p. 170–184
  24. Straus SE, Richard WS, Glasziou P, et al. Evidence based medicine. Philadelphia, PA: Churchill Livingstone; 2005;320
  25. Dworkin RH, Turk DC, Farrar JT, et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain. 2005;113:9–19
  26. Lazarski MP, Walker WA, Flores CM, et al. Epidemiological evaluation of the outcomes of nonsurgical root canal treatments in a large cohort of insured dental patients. J Endod. 2001;27:791–796
  27. Whyman RA, Treasure ET, Avers KM. Dental disease levels and reasons for emergency clinic attendance in patients seeking relief of pain in Auckland. N Z Dent J. 1996;92:114–117
  28. John MT, Koepsell TD, Hujoel P, et al. Demographic factors, denture status and oral health-related quality of life. Community Dent Oral Epidemiol. 2004;32:125–132
  29. Gedney JJ, Logan H, Baron RS. Predictors of short-term and long-term memory of sensory and affective dimensions of pain. J Pain. 2003;4:47–55
  30. Vanotti A, Osio M, Mailland E, et al. Overview on pathophysiology and newer approaches to treatment of peripheral neuropathies. CNS Drugs. 2007;21:3–12
  31. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174
  32. Werts R. Endodontic treatment: a five-year follow-up. Dent Surv. 1975;51:29–30
  33. Polycarpou N, Ng YL, Canavan D, et al. Prevalence of persistent pain after endodontic treatment and factors affecting its occurrence in cases with complete radiographic healing. Int Endod J. 2005;38:169–178
  34. Vandenbroucke JP, von Elm E, Altman DG, et al. STROBE initiative. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Ann Intern Med. 2007;147:W163–W194
  35. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–188
  36. Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–560
  37. American Dental Association. Survey of dental services rendered and distribution of dentists in the United States by region and state, 1999. American Dental Association; Chicago, IL,; 2002;
  38. Logan HL, Lutgendorf S, Kirchner HL, et al. Pain and immunologic response to root canal treatment and subsequent health outcomes. Psychosom Med. 2001;63:453–462
  39. Eitner S, Wichmann M, Paulsen A, et al. Dental anxiety—an epidemiological study on its clinical correlation and effects on oral health. J Oral Rehabil. 2006;33:588–593
  40. Hagglin C, Hakeberg M, Ahlqwist M, et al. Factors associated with dental anxiety and attendance in middle-aged and elderly women. Community Dent Oral Epidemiol. 2000;28:451–460
  41. Sohn W, Ismail AI. Regular dental visits and dental anxiety in an adult dentate population. J Am Med Assoc. 2005;136:58–66
  42. Gao D, Liu C, Li X. Clinical evaluation of glutaldehyde resinifying therapy on pulp diseases. Zhonghua Kou Qiang Yi Xue Za Zhi. 2000;35:209–211
  43. Van Doorne L, Vanderstraeten C, Rhem M, et al. CO2 laser sterilization in periradicular surgery: a clinical follow-up study. Rev Belge Med Dent. 1996;51:73–82
  44. Campbell RL, Parks KW, Dodds RN. Chronic facial pain associated with endodontic therapy. Oral Surg Oral Med Oral Pathol. 1990;69:287–290
  45. Marbach JJ, Hulbrock J, Hohn C, et al. Incidence of phantom tooth pain: an atypical facial neuralgia. Oral Surg Oral Med Oral Pathol. 1982;53:190–193
  46. Altonen M, Mattila K. Follow-up Study of apicoectomized molars. Int J Oral Surg. 1976;5:33–40
  47. Danin J, Linder LE, Lundqvust G, et al. Outcomes of periradicular surgery in cases with apical pathosis and untreated canals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87:227–232
  48. de Chevigny C, Dao TT, Basrani BR, et al. Treatment outcomes in Endodontics: the Toronto study-phases 3 and 4: orthograde retreatment. J Endod. 2008;34:131–137
  49. de Chevigny C, Dao TT, Basrani BR, et al. Treatment outcome in endodontics: the Toronto study-phase 4: initial treatment. J Endod. 2008;34:258–263
  50. Dietrich T, Zunker P, Dietrich D, et al. Periapical and periodontal healing after osseous grafting and guided tissue regeneration treatment of apicomarginal defects in periradicular surgery: Results after 12 months. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:474–482
  51. Farzaneh M, Abitbol S, Friedman S. Treatment outcome in endodontics: the Toronto study. phases I and II: orthograde retreatment. J Endod. 2004;30:627–633
  52. Farzaneh M, Abitbol S, Lawrence HP, et al. Toronto Study. Treatment outcome in endodontics-the Toronto study. phase II: initial treatment. J Endod. 2004;30:302–309
  53. Hession RW. Long-term evaluation of endodontic treatment: anatomy, instrumentation, obturation-the endodontic practice triad. Int Endod J. 1981;14:179–184
  54. Ioannides C, Borstlap WA. Apicoectomy on molars: a clinical and radiographical study. Int J Oral Surg. 1983;12:73–79
  55. Lyons AJ, Dixon EJA, Hughes CE. A 5-year audit of outcome of apicectomies carried out in a district general hospital. Ann R Coll Surg Engl. 1995;77:273–277
  56. Marquis VL, Dao T, Farzaneh M, et al. Treatment outcome in endodontics: the Toronto study. phase III: initial treatment. J Endod. 2006;32:299–306
  57. Seto BG, Beumer J, Kagawa T, et al. Analysis of endodontic therapy in patients irradiated for head and neck cancer. Oral Surg Oral Med Oral Pathol. 1985;60:540–545
  58. von Arx T, Berber C, Hardt N. Periradicular surgery of molars: a prospective clinical study with a one-year follow-up. Int Endod J. 2001;34:520–525
  59. Turp JC, Schulte JM, Antes G. Nearly half of all dental randomized controlled trials published in German are not included in Medline. Eur J Oral Sci. 2002;110:405–411
  60. Major MP, Major PW, Flores-Mir C. An evaluation of search and selection methods used in dental systematic reviews published in English. J Am Dent Assoc. 2006;137:1252–1257
  61. Moles DR, Needleman IG, Niederman R, et al. Introduction to cumulative meta-analysis in dentistry: lessons learned from undertaking a cumulative meta-analysis in periodontology. J Dent Res. 2005;84:345–349
  62. Spangberg LSW. Systematic reviews in endodontics—examples of GIGO?. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:723–724
  63. Cummings SR, Newman TB, Hulley SB. Designing a cohort study. In:  Cummings SR,  Newman TB,  Hulley SB editor. Designing clinical research. 3rd ed.. Philadelphia, PA: Lippincott, Williams & Wilkins; 2007;p. 97–107
  64. Friedman LM, Furberg CD, DeMets DL. What is the question?. In:  Friedman LM,  Furberg CD,  DeMets DL editor. Fundamentals of clinical trials. 3rd ed. New York, NY: Springer; 1998;p. 16–29
  65. Szklo M, Nieto FJ. Measuring disease occurrence. In:  Szklo M,  Nieto FJ editor. Epidemiology beyond the basics. 2nd ed. Sudbury, MA: Jones and Bartlett Publishers, Inc; 2007;p. 47–76
  66. Lobb WK, Zakariasen KL, McGrath PJ. Endodontic treatment outcomes: do patients perceive problems?. J Am Dent Assoc. 1996;127:597–600
  67. Savitz DA. Bias due to the loss of study participants. In: Savitz DA. Interpreting epidemiological evidence: Strategies for study design and analysis. New York, NY: Oxford University Press; 2003;p. 115–135
  68. Szklo M, Nieto FJ. Understanding lack of validity: Bias. In:  Szklo M,  Nieto FJ editor. Epidemiology beyond the basics. 2nd ed. Sudbury, MA: Jones and Bartlett Publishers, Inc; 2007;p. 107–150

 Supported by NCRR K12-RR023247 (Dr Nixdorf).

PII: S0099-2399(09)00950-9

doi: 10.1016/j.joen.2009.11.007

Journal of Endodontics
Volume 36, Issue 2 , Pages 224-230 , February 2010

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