Alleviation of acute dental pain from localised apical periodontitis : A prospective randomised study comparing two emergency treatment procedures

• Objective: To compare the outcomes of two emergency treatment procedures to alleviate pain from localised symptomatic apical periodontitis: complete chemo‐mechanical disinfection (CMD) of the root canal system, or removal of necrotic tissue from the pulp chamber (RNT), that is without instrumentation of the root canals. Methods: Fifty‐seven consecutive patients from the emergency clinic at Malmö University met the inclusion criteria: spontaneous pain and/or pain on percussion and palpation, non‐bleeding pulp in the canal orifice, pain ≥4 on a Numeric Rating Scale and ≥18 years of age. The diagnosis was symptomatic apical periodontitis, in the absence of swelling and/or fever. Pre‐operative pain levels and intake of analgesics were registered. The patients were randomised to one of the two treatment groups. Three to five days post‐operatively, the patients were contacted by telephone and asked to grade their current pain level and report any post‐operative intake of analgesics and antibiotics. Results: Of the patients treated with CMD of the root canal system, 26/30 (87%) reported satisfactory pain relief, compared with 22/27 (81%) of those treated by RNT. There was no mean difference in pain relief between the two groups (P = 0.879). Post‐operatively, 37% in each group reported using analgesics and one in each group reported using antibiotics. Conclusion: Three to five days after treatment, a majority (>80%) in both groups reported adequate pain relief, in some cases in combination with analgesics. Removal of necrotic and infected tissue from the pulp chamber might therefore be a cost‐effective emergency treatment alternative to complete chemo‐mechanical disinfection.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Odontologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dentistry (hsv//eng)

Keyword

chemo-mechanical disinfection

necrotic tissue

pain

root canal infection

rubber dam

symptomatic

Publication and Content Type

ref (subject category)

art (subject category)