Relationship between post-endodontic pain, tooth diagnostic factors, and apical patency

By Arias N, Azabal M, Hidalgo J, de la Macorra J.

Date: 01/2009
Journal: JOE


Purpose-assess whether maintaining apical patency might influence the incidence, degree, or duration of post op pain considering the tooths preop diagnosis and its location.


-300 (n=236 responded for survey) NSRCT’s were performed by 1 clinician in single visit. Following WL determination with EAL, canals were cleaned and shaped.

-Recorded pulp vitality, presence/absence of preop pain, location of tooth

Group 1: patency maintained throughout w/ #10 k-file 1mm beyond apex.

Group 2: Following WL establishment all efforts made to avoid surpassing WL at all times throughout procedure.


  • In non-vital teeth less post-operative pain was observed in patency group (stat. sig)
  • If pre-op pain present – post-op pain was more significant in patency group.
  • In lower teeth – post-op pain was significantly longer in patency group.

Clinical Significance:

Maintaining patency in non-vital should not increase post op pain as long as file used is small. Maintaining patency throughout procedure in teeth with preop pain & mandibular teeth may increase post op pain.