SP-29 Neuropathic Pain After Root Canal Treatment

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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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