International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 17 , ISSUE 7 ( July, 2024 ) > List of Articles

REVIEW ARTICLE

Flare-ups in Primary Teeth Before, During, and After Pulpectomy: A Systematic Review and Meta-analysis

M Srinivas Moudgalya, Parimala Kulkarni, Shilpi Tiwari, Shikha Mali, Anoop Kumar Shrivas, Shubhrata Shrivastava

Keywords : Flare-ups in primary teeth, Postobturation complications in primary teeth, Postoperative pain after pulpectomy

Citation Information : Moudgalya MS, Kulkarni P, Tiwari S, Mali S, Shrivas AK, Shrivastava S. Flare-ups in Primary Teeth Before, During, and After Pulpectomy: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2024; 17 (7):838-841.

DOI: 10.5005/jp-journals-10005-2951

License: CC BY-NC 4.0

Published Online: 12-09-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

To determine the pain prevalence and severity of flare-ups associated with before, during, and after pulpectomy procedure in children through systematic review and meta-analysis. Pain associated with root canal is a crucial source of fear for patients (especially child patients) and an important concern of dentists. Pain experienced at pretreatment, during treatment, and posttreatment is foreseen and recalled by child patients. A hand search of relevant journals and defined searching of Medline/PubMed, Cochrane, and EBSCOhost databases identified 2,635 articles reporting flare-ups at different intervals. After further filtering and applying inclusion criteria, three articles were identified for meta-analysis. From three recognized articles in the pretreatment phase, 51.2% of cases reported flare-ups; during treatment, there were 19.8% of cases; and in the posttreatment phase, 100% success rate was seen (i.e., no flares were present). The three included studies were heterogeneous according to I2 and τ2 statistics (p <0.001, I2 = 92.64). Pretreatment pulpectomy-associated flare-ups were high, then dropped significantly to minimal levels in 3 days (during treatment) and continued to drop to lowest levels in 7 days (posttreatment).


PDF Share
  1. Udoye CI, Oginni AO, Oginni FO. Dental anxiety among patients undergoing various dental treatments in a Nigerian teaching hospital. J Contemp Dent Pract 2005;6(2):91–98.
  2. Sipavičiūtė E, Manelienė R. Pain and flare-up after endodontic treatment procedures. Stomatologija 2014;16(1):25–30.
  3. Chiappelli F, Prolo P, Rosenblum M, et al. Evidence-based research in complementary and alternative medicine II: the process of evidence-based research. Evid Based Complement Alternat Med 2006;3(1):3–12.
  4. Nair M, Jeevanandan G, Vignesh R, et al. Comparative evaluation of post-operative pain after pulpectomy with K-files, Kedo-S files and Mtwo files in deciduous molars—a randomized clinical trial. Braz Dent Sci 2018;21(4).
  5. Sevekar SA, Gowda SHN. Postoperative pain and flare-ups: comparison of incidence between single and multiple visit pulpectomy in primary molars. J Clin Diagn Res 2017;11(3):ZC09–ZC12.
  6. Topçuoğlu G, Topçuoğlu HS, Delikan E, et al. Postoperative pain after root canal preparation with hand and rotary files in primary molar teeth. Pediatr Dent 2017;39(3):192–196.
  7. Van Wijk AJ, Hoogstraten J. Reducing fear of pain associated with endodontic therapy. Int Endod J 2006;39(5):384–388.
  8. Shokraneh A, Ajami M, Farhadi N, et al. Postoperative endodontic pain of three different instrumentation techniques in asymptomatic necrotic mandibular molars with periapical lesion: a prospective, randomized, double-blind clinical trial. Clin Oral Investig 2017;21(1):413–418.
  9. Seymour RA, Blair GS, Wyatt FAR. Post-operative dental pain and analgesic efficacy. Part I. Br J Oral Surg 1983;21(4):290–297.
  10. Hill CM, Carroll MJ, Giles AD, et al. Ibuprofen given pre-and post-operatively for the relief of pain. Int J Oral Maxillofac Surg 1987;16(4):420–424.
  11. Attar S, Bowles WR, Baisden MK, et al. Evaluation of pretreatment analgesia and endodontic treatment for postoperative endodontic pain. J Endod 2008;34(6):652–655.
  12. Oginni AO, Udoye CI. Endodontic flare-ups: comparison of incidence between single and multiple visit procedures in patients attending a Nigerian teaching hospital. BMC Oral Health 2004;4(1):4.
  13. Wong AWY, Zhang C, Chu C. A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment. Clin Cosmet Investig Dent 2014;6:45–56.
  14. Su Y, Wang C, Ye L. Healing rate and postobturation pain of single- versus multiple-visit endodontic treatment for infected root canals: a systematic review. J Endod 2011;37(2):125–132.
  15. Siquiera JF Jr. Micorbial causes of endodontic flare-ups. Int Endod J 2003;36(7):453–463.
  16. American Academy on Pediatric Dentistry Clinical Affairs Committee-Pulp Therapy subcommittee; American Academy on Paediatric Dentistry Council on Clinical Affairs. Guideline on pulp therapy for primary and young permanent teeth. Pediatr Dent 2008;30(7 Suppl.):170–174.
  17. Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review. Int Endod J 2008;41(2):91–99.
  18. Risso PA, Cunha AJLA, Araujo MCP, et al. Postobturation pain and associated factors in adolescent patients undergoing one- and two-visit root canal treatment. J Dent 2008;36(11):928–934.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.