OS-09 Central Sensitization, Neuropathic Pain and Implications on Endodontic Treatment
CE Hours: 1.0
Description: Central sensitization is a critical mechanism underlying persistent pain following root canal therapy. It occurs when the central nervous system enters a prolonged state of hyperexcitability, leading to the amplification of pain. This phenomenon contributes to the development of neuropathic pain, which may affect approximately 1-12% of patients after endodontic procedures. One proposed mechanism is deafferentation, where the removal or injury of pulp afferent neurons disrupts normal sensory input. This disruption can trigger maladaptive neuroplastic changes, including activation of glial cells, which perpetuate a hyperexcitable state and reinforce chronic pain pathways. Preventing neuropathic pain begins during endodontic therapy. Minimizing neural trauma, recognizing early signs of sensitization, and applying evidence-based pain management strategies are essential to improving patient outcomes. This lecture aims to clarify central sensitization in endodontic therapy, its relationship with neuropathic pain, and the implications of these occurrences in endodontic treatment.
Learning Objectives:
- Identify signs of central sensitization in endodontic patients
- Define the neurobiological mechanisms linking endodontic procedures to neuropathic pain
- Implement preventive strategies to reduce the risk of persistent post-treatment pain
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LockedHelena F. Filippini, D.D.S., M.S, Ph.D
Dr. Filippini is an assistant professor of Endodontics at Virginia Commonwealth University. She received a D.D.S. from the Lutheran University of Brazil in 1998. In 2002, she got her Master of Science degree in Endodontics from the same university. Dr. Filippini completed her residencies in Endodontics (2001) and TMJ and orofacial pain (2010) at the Brazilian Association of Dentistry in Brazil. After that, she got a grant from the Brazilian Government that allowed her to do part of her Ph.D studies in Canada at Dr. Barry Sessle's Lab at the University of Toronto. During her Ph.D., her research was focused on the mechanisms of dental pain and central sensitization, specifically exploring the roles of glial cells and toll-like receptors. She continued to expand her expertise through postdoctoral fellowships in Neuroscience at Dr. Avivi-Arber's lab at the School of Dentistry and at Dr. Bonin's Lab at the School of Pharmacy, both at the University of Toronto. Her studies aimed to understand nociceptive behaviors in mice, particularly the neuropharmacology of hanging behavior that is decreased under inflammatory and neuropathic pain. In addition, Dr. Filippini worked as an adjunct professor at the Lutheran University of Brazil for over 16 years. Her teaching experience focused on Endodontics, Comprehensive care clinics, Physiology, and Microbiology. She also had her private practice in Brazil for over 20 years, focusing on Endodontics and Orofacial pain therapies. Her research interests are dental pain, glial cells, rodent behavior, and pain modulation.
Disclosure(s): No financial relationships to disclose