Flare-ups after endodontic treatment: a meta-analysis of literature

By Tsesis I, Faivishevsky V, Fuss Z, Zukerman O.

Date: 01/2008
Journal: JOE


Determine the frequency of flare-ups and to evaluate factors that affect it by using meta-analysis of results of previous studies. Flare-up is defined as a strong pain with or without swelling that occurs after the initiation or continuation of root canal treatment


MEDLINE database searched using keywords “flare-up,” “interappointment pain,” “post-obturation pain,” etc. Inclusion criteria: Randomized control trials, case series, detailed diagnosis, pain within 24-48 hrs, severe pain estimated by using VAS system. Weighted average and chi-square tests used. 6 studies included (1989-2006).


  • Average percentage of flare-ups for 982 patients was 8.4%
  • No significant differences for gender or number of appointments

Clinical Significance:

  • Flare-ups can happen with about 8% of patients within 48 hours after the procedure. Plan accordingly to manage them appropriately.