SP-29 Neuropathic Pain After Root Canal Treatment
CE Hours: 0.75
Description: Studies have shown that neuropathic pain occurs in 1 to 12% of the patients after root canal treatment. Due to the difficulties of diagnosis, this kind of pain is undertreated, and the patients have a history of repeated unsuccessful therapies. This presentation aims to discuss the mechanisms of its occurrence, how this pain differs from odontogenic pain, the recommended management, and how to prevent this kind of pain during root canal therapy. Among the theories of neuropathic pain, deafferentation is one of the most studied. Afferent neurons from the pulp, after their excision, can lead to chronic pain due to deafferentation. This occurrence involves central sensitization, leading to hyperexcitability of nociceptor neurons in the trigeminal system and persistent pain. In addition, this phenomenon includes glial cell activation. The clinician needs to identify this pain in their practice. The treatment is multidisciplinary and focused on the neurochemistry of this addicted neural circuit. Usually, the prevention of it can be done during endodontic therapy.
Learning Objectives:
- Distinguish neuropathic pain from odontogenic pain.
- Discuss effective treatment options.
- Prevent neuropathic pain during endodontic therapy.
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Helena 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