Alhilou Abdelrahman M
Department of Restorative Dentistry, College of Dentistry, Umm Al-Qura University, Makkah 24382, Saudi Arabia.
Dent J (Basel). 2025 Feb 26;13(3):102. doi: 10.3390/dj13030102.
Pain after root canal treatment is a common concern that can greatly affect a patient's quality of life. Identifying the factors contributing to this pain and focusing on those supported by high-quality research can lead to more effective pain management. This narrative review aims to analyze all available systematic reviews on this topic to determine what has been proven to help decrease pain following the root canal procedure. A comprehensive literature search was conducted across Scopus and Google Scholar from January 2000 to January 2024, using defined MeSH terms. This yielded 51 systematic reviews, of which 45 specifically investigated factors reducing postoperative pain related to root canal treatment. Eleven factors were identified in the literature, with only eight factors supported by low- to moderate-quality evidence to reduce postoperative pain related to root canal treatment. These eight factors include (1) laser therapy, (2) nonsteroidal anti-inflammatory drugs (especially when combined with acetaminophen) and corticosteroids, (3) ultrasonic irrigation and low concentrations of sodium hypochlorite, (4) cryotherapy, (5) specific combinations of intracanal medicaments (notably calcium hydroxide with chlorhexidine), (6) bioceramic sealers, (7) rotary instrumentation, and (8) apical patency. The insights gained from this narrative review highlight several important factors that reduce postoperative pain related to root canal treatment. Nevertheless, the observed variability in the quality of the evidence calls attention to the necessity for further high-quality research.
根管治疗后的疼痛是一个常见问题，会极大地影响患者的生活质量。识别导致这种疼痛的因素，并关注那些有高质量研究支持的因素，可实现更有效的疼痛管理。本叙述性综述旨在分析关于该主题的所有现有系统评价，以确定已被证明有助于减少根管治疗后疼痛的因素。从2000年1月至2024年1月，使用定义的医学主题词（MeSH）在Scopus和谷歌学术上进行了全面的文献检索。这产生了51篇系统评价，其中45篇专门研究了与根管治疗相关的减轻术后疼痛的因素。文献中确定了11个因素，其中只有8个因素有低至中等质量的证据支持可减少与根管治疗相关的术后疼痛。这8个因素包括：（1）激光治疗；（2）非甾体抗炎药（尤其是与对乙酰氨基酚联合使用时）和皮质类固醇；（3）超声冲洗和低浓度次氯酸钠；（4）冷冻疗法；（5）根管内药物的特定组合（特别是氢氧化钙与氯己定）；（6）生物陶瓷封闭剂；（7）旋转器械；（8）根尖通畅。从本叙述性综述中获得的见解突出了几个减少与根管治疗相关的术后疼痛的重要因素。然而，证据质量中观察到的变异性提醒人们有必要进行进一步的高质量研究。
