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J Endod ; 40(12): 1917-21, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25220076


INTRODUCTION: The frequency of persistent pain 3-5 years after primary root canal therapy and its impact on the patient's perceived oral health-related quality of life was determined in a practice-based research network. METHODS: All patients presenting to participating network practices who received primary root canal therapy and restoration for a permanent tooth 3-5 years previously were invited to enroll. Persistent pain was defined as pain occurring spontaneously or elicited by percussion, palpation, or biting. The patient also completed an oral health-related quality of life questionnaire (Oral Health Impact Profile-14). RESULTS: Sixty-four network practices enrolled 1323 patients; 13 were ineligible, 12 did not receive a final restoration, and 41 were extracted, leaving 1257 for analysis. The average time to follow-up was 3.9 ± 0.6 years. Five percent (63/1257) of the patients reported persistent pain, whereas 24 of 63 (38%) exhibited periapical pathosis and/or root fracture (odontogenic pain). No obvious odontogenic cause for persistent pain was found for 39 of 63 (62%). Teeth treated by specialists had a greater frequency of persistent pain than teeth treated by generalists (9.3% vs 3.0%, respectively; P < .0001). Sex, age, tooth type, type of dentist, and arch were not found to be associated with nonodontogenic persistent pain; however, ethnicity and a preoperative diagnosis of pulpitis without periapical pathosis were. Patients reporting pain with percussion tended to experience pain with other stimuli that negatively impacted quality of life including oral function and psychological discomfort and disability. CONCLUSIONS: These results suggest that a small percentage (3.1%) of patients experience persistent pain not attributable to odontogenic causes 3-5 years after primary root canal therapy that may adversely impact their quality of life.

Salud Bucal , Dolor/epidemiología , Calidad de Vida , Tratamiento del Conducto Radicular/estadística & datos numéricos , Adolescente , Adulto , Anciano , Investigación Participativa Basada en la Comunidad , Femenino , Estudios de Seguimiento , Odontología General/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , New York/epidemiología , Dolor/psicología , Enfermedades Periapicales/epidemiología , Enfermedades Periapicales/psicología , Prevalencia , Pulpitis/epidemiología , Pulpitis/psicología , Tratamiento del Conducto Radicular/psicología , Especialidades Odontológicas/estadística & datos numéricos , Fracturas de los Dientes/epidemiología , Fracturas de los Dientes/psicología , Raíz del Diente/lesiones , Adulto Joven
J Endod ; 40(6): 805-10, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24862707


INTRODUCTION: To date, evidence of the effectiveness of endodontic treatment and criteria of success have mainly been considered in terms of clinical outcome, and there is a lack of information of treatment outcomes from patients' perspectives. This study aimed to assess changes in quality of life after endodontic treatment and to determine if changes in quality of life were associated with changes in patient-perceived oral health and clinical assessments of success. METHODS: This longitudinal study involved 279 subjects. Patient-reported outcome measures based on oral health-related quality of life was assessed using the short form of the Oral Health Impact Profile (OHIP-14). The patients completed the assessments before endodontic treatment and 1 month and 6 months after root canal obturation. A global oral health transition assessment was ascertained by a single (global) item rating of oral health improvement and clinical assessment mainly based on the Periapical Index (PAI) of periapical radiographs. RESULTS: There were significant changes in OHIP-14 scores over the study period after conventional orthograde endodontic treatment (from pretreatment-6 months postobturation) (P < .001). The magnitude of statistical change (effect size) was moderate (0.61) in the short-term (after 1 month) and large (0.71) in the longer-term (after 6 months). Changes in the OHIP-14 was associated with changes in patient self-rating oral health status (P < .001), which was also associated with changes in PAI scores (P < .05). CONCLUSIONS: Endodontic treatment improves quality of life. The OHIP-14 measure is both sensitive and responsive to endodontic treatment and is likely to be useful in understanding patients' perspectives of outcomes from endodontic care.

Salud Bucal , Calidad de Vida , Tratamiento del Conducto Radicular/psicología , Adulto , Actitud Frente a la Salud , Índice CPO , Enfermedades de la Pulpa Dental/psicología , Femenino , Estudios de Seguimiento , Estado de Salud , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Enfermedades Periapicales/psicología , Índice Periodontal , Estudios Prospectivos , Radiografía de Mordida Lateral , Obturación del Conducto Radicular/psicología , Autoinforme , Resultado del Tratamiento
J Endod ; 38(1): 86-90, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22152627


INTRODUCTION: Cannabinoid receptor 2 (CB2) is an intriguing target for the treatment of pain because of its ability to mediate analgesia without psychoactive effects, but little is known about the role of CB2 in pain of endodontic origin. The purpose of this study was to determine the behavioral effects of dental pulp exposure in wild-type (WT) mice and to explore the contribution of CB2 to these behaviors using CB2 knockout (CB2 KO) mice. METHODS: Pulp exposures were created unilaterally in the maxillary and mandibular first molars of female WT and CB2 KO mice. The open field test was used before pulp exposure or sham surgery, and postoperatively at 1 day, 1 week, 2 weeks, and 3 weeks. Mouse body weight and food consumption were recorded preoperatively and postoperatively at 1 day, 2 days, and 1 week. RESULTS: At baseline, CB2 KO mice weighed significantly more and had significantly greater food intake than WT mice. CB2 KO mice exhibited greater anxiety-like behavior in the baseline open field test, having significantly fewer center crossings and less distance traveled than WT mice. Pulp exposure had relatively little effect on the behavior of WT mice. CB2 KO mice with pulp exposures showed a decrease in food intake and body weight after surgery, and pulp exposure resulted in significantly fewer center crossings in the open field test in CB2 KO mice. CONCLUSIONS: Pulp exposure in CB2 KO mice resulted in behaviors consistent with an increase in pain and/or anxiety.

Conducta Animal , Exposición de la Pulpa Dental/psicología , Receptor Cannabinoide CB2/fisiología , Animales , Ansiedad/fisiopatología , Ansiedad/psicología , Peso Corporal/fisiología , Exposición de la Pulpa Dental/patología , Exposición de la Pulpa Dental/fisiopatología , Ingestión de Alimentos/fisiología , Femenino , Ratones , Ratones Noqueados , Diente Molar/patología , Dolor/fisiopatología , Dolor/psicología , Enfermedades Periapicales/fisiopatología , Enfermedades Periapicales/psicología , Receptor Cannabinoide CB2/genética , Factores de Tiempo , Caminata/fisiología