Factors Reducing Postoperative Pain Related to Root Canal Treatment: A Narrative Review of Systematic Reviews

Abstract

Background/Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.

Keywords: endodontics; pain; postoperative; root canal therapies.

Figure 1

Flowchart illustrating the process of article selection.