Ali Nosrat1, Omid Dianat2, Prashant Verma3, Donald R Nixdorf4, Alan S Law5. 1. - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland Baltimore, Maryland; - Private Practice, Centreville Endodontics, Centreville, Virginia. Electronic address: Nosrat@umaryland.edu. 2. - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland Baltimore, Maryland. 3. - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland Baltimore, Maryland; - Private Practice, Centreville Endodontics, Centreville, Virginia; - Private Practice, Capitol Endodontics, Washington, District of Columbia. 4. - Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, Minnesota; - Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota; - HealthPartners Institute for Education and Research, Bloomington, Minnesota. 5. - Private Practice, The Dental Specialists, Lake Elmo, Minnesota; - Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota.
Abstract
INTRODUCTION: Examining the evolution of research parameters helps scientists to discover the well-developed and the neglected aspects of knowledge. Pain after root canal treatment is a health problem affecting millions of patients. Research in this field has a meaningful impact on quality of lives. The aim of this study was to analyze the evolution of research on post-operative pain over the past 50 years. METHODS: Electronic searches were performed in Scopus and MEDLINE databases to identify studies on pain after non-surgical root canal treatments/retreatments. The full texts of eligible articles were reviewed to determine the study category, and to extract and analyze the methodological variables. A series of statistical analyses were performed to determine the trend of publications based on variable of interest overtime. RESULTS: 424 articles were included. There was a positive trend for systematic reviews, studies with sample size <200, studies on single-visit treatment, and clinical trials on instrumentation and adjunct treatments (P<0.05). There was a negative trend for use of numeric rating scales, studies on multiple-visit treatments, clinical trials on medication/medicament, and studies on pain in maxillary incisors (P<0.05). No trend was observed based on pulpal diagnosis or for studies with longer observation periods (>8 weeks) (P>0.05). CONCLUSIONS: A paradigm shift is needed towards clinical studies with larger sample sizes, longer observation periods, and more focus on pulpal diagnoses associated with higher rates of post-operative pain. There is a need to view post-operative pain as an important patient-centered outcome, and to develop and disseminate standard reporting guidelines for future studies.
INTRODUCTION: Examining the evolution of research parameters helps scientists to discover the well-developed and the neglected aspects of knowledge. Pain after root canal treatment is a health problem affecting millions of patients. Research in this field has a meaningful impact on quality of lives. The aim of this study was to analyze the evolution of research on post-operative pain over the past 50 years. METHODS: Electronic searches were performed in Scopus and MEDLINE databases to identify studies on pain after non-surgical root canal treatments/retreatments. The full texts of eligible articles were reviewed to determine the study category, and to extract and analyze the methodological variables. A series of statistical analyses were performed to determine the trend of publications based on variable of interest overtime. RESULTS: 424 articles were included. There was a positive trend for systematic reviews, studies with sample size <200, studies on single-visit treatment, and clinical trials on instrumentation and adjunct treatments (P<0.05). There was a negative trend for use of numeric rating scales, studies on multiple-visit treatments, clinical trials on medication/medicament, and studies on pain in maxillary incisors (P<0.05). No trend was observed based on pulpal diagnosis or for studies with longer observation periods (>8 weeks) (P>0.05). CONCLUSIONS: A paradigm shift is needed towards clinical studies with larger sample sizes, longer observation periods, and more focus on pulpal diagnoses associated with higher rates of post-operative pain. There is a need to view post-operative pain as an important patient-centered outcome, and to develop and disseminate standard reporting guidelines for future studies.