[Alternative solutions for postoperative pain in teeth with necrotic pulp]

Both the literature and clinical experience have verified that necrotic root canals, with or without periapical lesion, display a confusing response to the various tests for pulp vitality. As suggested by clinical and histopathological research studies, these lesions are due to a defense reaction from the periapical connective tissue, in response to bacterial infections which alter host tissues. Diminishing the frequency of postoperative pain in endodontic treatment is currently a leading concern, and this study aimed to evaluate the different variables involved in root canal therapy, so as to recommend the most suitable approach, without losing sight of the main goal at hand: a successful endodontic treatment. The present study was performed on 200 necrotic root canals, using frontal teeth, upper and lower premolars and molars, both with straight or curved canals. Avoiding damage to the periapical regions, the study concluded, is of prime importance in lowering the frequency of postoperatory pain. Also, the presence of periapical pain is vitally important in the appearance of postoperatory pain, and it is in such cases that cleansing must be adopted as a routine clinical procedure.