Factors associated with endodontic posttreatment pain

One hundred six patients with pretreatment pain presenting for endodontic treatment participated in a controlled double-blind study of dexamethasone use. Endodontic therapy was performed and, after controlling for use or nonuse of dexamethasone, patient variables and treatment factors were evaluated for their effects on endodontic posttreatment pain. Patients with no radiographic periapical lesions had significantly more pain than patients with periapical lesions at 8-, 24-, 48-, and 72-h posttreatment regardless of whether they received placebo or dexamethasone. No other patient or treatment factors correlated with posttreatment pain. Twenty-two patients in the subgroup receiving placebo reported an 81% incidence of posttreatment pain, 73% of them required posttreatment pain medications. By 72-h posttreatment, the incidence and severity of pain in the placebo group was minimal.