Predicting pre- and postoperative pain of endodontic origin in a southern Brazilian subpopulation: an electronic database study.

AIM: To determine the prevalence of preoperative endodontic pain (PREP) and the incidence of postoperative endodontic pain (POEP), identifying the predictors of PREP and POEP in a southern Brazilian subpopulation, using clinical data from an electronic chart database (ECD). METHODOLOGY: This retrospective observational study included 563 consecutive individuals presenting for root canal treatment (RCT). Patients were treated by undergraduate and graduate students, following standard RCT protocols. Demographic, medical and dental variables were extracted from a pre-structured and standardized ECD. The main outcomes PREP and incident POEP were collected through a 0-10 numeric rating scale, dichotomized as none/mild (<4) or moderate/severe (≥4) pain. Predictive models calculating the prevalence ratios (PR) of PREP and the relative risks (RR) of incident POEP were carried out with Poisson regression analysis, estimating the relationship between clinical factors, PREP and incident POEP. RESULTS: Mean age at baseline was 49.2 ± 17.1 years, with 68.4% women. The prevalence and incidence of moderate/severe PREP and POEP were 44.4% and 3.8%, respectively. RCT intervention significantly reduced PREP (P < 0.001). Multivariate analysis revealed that group of teeth, location (mandibular teeth), pulpitis, necrotic pulp, preoperative swelling and periapical radiolucency were independently associated with moderate/severe PREP, whilst age ≥60 years and root canal retreatments were independent protective factors to PREP (P < 0.05). No demographic, medical or dental variables were associated with POEP, although molar teeth (RR = 4.23, 95%CI = 0.93-19.2, P = 0.056) had a borderline nonsignificant association. CONCLUSIONS: Moderate/severe PREP was independently associated with age, group of teeth, location, preoperative swelling, retreatments and pulp and periapical status. No demographic, medical or dental variable predicted moderate/severe POEP following RCT amongst this subpopulation.

Effect of the pro-resolution lipid mediator Resolvin E1 (RvE1) on pulp tissues exposed to the oral environment.

AIM: To evaluate the effects of topical Resolvin E1 (RvE1) application on infected dental pulps. METHODOLOGY: Forty-two male Wistar rats (n = 6 per three groups/and two time periods) were used. To induce inflammation, pulps in mandibular right first molars were accessed and then left exposed to the oral environment for 24 h. After this period, topical medication with a corticosteroid/antibiotic blend, or RvE1, or its vehicle (Ethanol 0.1%) was directly applied onto the pulp tissue and teeth were restored with silver amalgam. The effects of the protocols were evaluated histologically and compared with control pulps not exposed to the oral environment. The inflammatory changes after 24 and 72 h were assessed through a scoring method and analysed using the Kruskal-Wallis test followed by Dunn's. Differences were considered significant if P < 0.05 (CI = 95%). RESULTS: Ethanol and corticosteroid/antibiotic treatment were not effective in arresting severe inflammatory alterations of exposed pulps at 24 and 72 h (P < 0.05, CI = 95%). At both time periods, RvE1 treatment led to a reduction of tissue cellularity and extent of inflammation, whose changes were not different from control pulps (P > 0.05, CI = 95%). CONCLUSIONS: A protective role for RvE1 in pulp inflammation was observed even in the presence of contamination, suggesting that it may be a candidate for a novel therapeutic strategy for conservative dental pulp treatment.