Postendodontic pain: A practical approach to diagnosis and management

Divya Kohli, Carla Falcon, Giannina Katzmann, Rafael Benoliel, Junad Khan, Olga A. Korczeniewska

Research output: Contribution to journalArticlepeer-review


Objectives: Endodontic treatment is a routine procedure per formed by general dental practitioners and endodontists on a daily basis. Fortunately, most patients undergoing endodontic therapy show a favorable outcome with uneventful healing. However, some patients develop pain following endodontic therapy. A majority of these patients develop acute, nocicep tive pain (“flare-up”) that resolves with appropriate treatment and subsequent healing. The dental profession is very adept at successfully managing the acute pain that occurs early follow ing endodontic treatment. A minority of patients, however, develop ongoing pain following root canal therapy, termed chronic if persisting for 3 months or more. The diagnosis and management of chronic postendodontic pain are often chal lenging. This article aims to review pain following endodontic therapy, ranging from acute to chronic pain and its manage ment, with specific emphasis on chronic pain, its pathophysi ology, clinical features, diagnostic criteria, and management modalities. Conclusion: Endodontic treatment rarely leads to chronic neuropathic pain; however, when the nerve injury oc curs and results in posttraumatic trigeminal neuropathic pain (PTNP), treatment options are very limited and rarely success ful. Therefore, all steps should be taken to avoid nerve injury. Prevention of endodontic treatment related PTNP is crucial and achieved through early recognition, and prompt management.

Original languageEnglish (US)
Pages (from-to)384-392
Number of pages9
JournalQuintessence international
Issue number5
StatePublished - May 1 2021

All Science Journal Classification (ASJC) codes

  • Dentistry(all)


  • Acute pain
  • Chronic pain
  • Endodontics
  • Neuropathic pain
  • Postendodontic therapy
  • Traumatic nerve injury
  • Trigeminal nerve


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