Abstract
Introduction
Little is known about the frequency of persistent pain after endodontic procedures
even though pain is a core patient-oriented outcome. We estimated the frequency of
persistent pain, regardless of etiology, after endondontic treatment.
Methods
Persistent tooth pain was defined as pain present ≥6 months after endodontic treatment.
Endodontic procedures included in the review were pulpectomy, nonsurgical root canal
treatment, surgical root canal treatment, and retreatment. Four databases were searched
electronically complemented by hand searching. Two independent reviewers determined
eligibility, abstracted data, and assessed study quality. A summary estimate of persistent
all-cause tooth pain frequency was established by using a random-effects meta-analysis.
Using subgroup analyses, we explored the influence of treatment approach (surgical/nonsurgical),
longitudinal study design (prospective/retrospective), follow-up rate, follow-up duration,
initial treatment versus retreatment, and quality of reporting (Strengthening the
Reporting of Observational Studies in Epidemiology rankings) on the pain frequency
estimate.
Results
Of 770 articles retrieved and reviewed, 26 met inclusion criteria. A total of 5,777
teeth were enrolled, and 2,996 had follow-up information regarding pain status. We
identified 168 teeth with pain and derived a frequency of 5.3% (95% confidence interval,
3.5%-7.2%, p < 0.001) for persistent all-cause tooth pain. High and statistically significant
heterogeneity among studies (I2 = 80%) was present. In subgroup analysis, prospective studies had a higher pain frequency
(7.6%) than retrospectives studies did (0.9%). Quality of study reporting was identified
as the most influential reason for study heterogeneity.
Conclusions
The frequency of all-cause persistent tooth pain after endodontic procedures was estimated
to be 5.3%, with higher report quality studies suggesting >7%.
Key Words
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Article info
Footnotes
Supported by NCRR K12-RR023247 (Dr Nixdorf).
Identification
Copyright
© 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
