Prevalência de flare-ups pós-tratamento endodôntico nas clínicas do Departamento de Odontologia - UFRN

Abstract

This study investigated the prevalence and associated factors of “flare-ups”—acute exacerbations of pain occurring hours or days after endodontic interventions, prompting patients to return early to the clinic. Conducted in the academic clinics of the Dentistry Department at UFRN and approved by the ethics committee of the Piracicaba School of Dentistry—UNICAMP, the study followed all patients for 48 hours post-treatment. Data collection included dental records, pain assessment using a Visual Analog Scale (VAS), and characterization of treatment type (retreatment, biopulpotomy, necropulpotomy), instrumentation method (manual or mechanized), and use of intracanal medication. Results showed a 29% prevalence of flare-ups, with the highest incidence in retreatments, followed by biopulpotomies and necropulpotomies, underscoring the importance of clinical history and preexisting tooth condition. The mean pain intensity reported was 6/10 on the VAS, most commonly in molars and premolars. Mechanized instrumentation and intracanal medications were notable risk factors associated with flare-ups. In summary, postoperative pain remains a significant complication in endodontics, affecting nearly one-third of treatments—particularly in retreatments and previously compromised teeth. The moderate pain intensity, especially in posterior teeth, and its association with mechanized techniques and intracanal medication highlight the need for well defined, individualized clinical protocols. These findings stress the importance of understanding and preventing postoperative pain in endodontic practice to improve patient quality of life and reduce unexpected return visits.