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ENDO - Endodontic Practice Today

Edited by Antionio Bonaccorso, Bun San Chong, Edgar Schafer, and Luc van der Sluis

Official Publication of the Belgian Association for Endodontology and Traumatology (BAET), the French Society of Endodontics (SFE) and the Norwegian Endodontic Society (NEF)

ISSN (print) 1753-2809 • ISSN (online) 1753-2817


Winter 2009
Volume 3 , Issue 4

Pages: 269 - 274
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Outlining the causes of peristent post-treatment pain in endodontics

Siqueira Jr., José F / Rôcas, Isabela N / Veiga, Leonardo M / Lopes, Hélio P / Oliveira, Julio CM / Alves, Flávio RF

Chronic 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; iii) 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.

Keywords: apical periodontitis, cone-beam computed tomography, endodontic treatment, persistent infection, post-treatment pain, secondary infection

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