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Management of Persistent Post-Endodontic Pain With a Standardized Gabapentin Pyramid Protocol: A Case Series and
Zakery James1, Biraj Patel2, Jianing He3
1Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Afton Endodontics, Concord, North Carolina.
Journal of Endodontics
|January 19, 2025
Summary
Persistent postendodontic pain can be effectively managed using the Gabapentin Pyramid Protocol. This standardized approach showed significant symptom relief in most patients, offering a new treatment option for this challenging condition.
Area of Science:
- Endodontics
- Pain Management
- Neurology
Background:
- Persistent postendodontic pain is a rare but significant clinical challenge.
- Peripheral neuropathy and central sensitization are implicated in its development.
- Effective management strategies are needed for refractory cases.
Purpose of the Study:
- To describe a management plan for persistent postendodontic pain.
- To provide prescription guidelines for the Gabapentin Pyramid Protocol.
- To evaluate the efficacy of this protocol in a case series.
Main Methods:
- Four cases of persistent postendodontic pain were analyzed.
- Peripheral pain etiologies were ruled out.
- Patients were treated with the standardized Gabapentin Pyramid Protocol after failing conventional analgesics.
Main Results:
- Three out of four patients experienced complete symptom resolution.
- One patient had significant symptom reduction, with recurrence upon drug discontinuation.
- The protocol demonstrated notable efficacy in managing persistent pain.
Conclusions:
- The Gabapentin Pyramid Protocol is an effective treatment for persistent postendodontic pain.
- This protocol offers significant symptom relief and potential for complete resolution.
- Standardized gabapentin dosing may improve clinical outcomes for this condition.
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