The Triad of Success: Evaluating Pain Alleviation, Chewing Efficiency, and Anxiety Reduction Post-RCT - A Prospective...

This prospective cohort study evaluated the interrelationship between pain alleviation, chewing efficiency, and anxiety reduction following root canal treatment (RCT) to establish a comprehensive "triad of success" framework for patient-centered outcomes.

In total, 150 patients undergoing single-rooted RCT were assessed preoperatively and at 24 h, 48 h, 7 days, and 30 days post-treatment. Pain was measured using a 100-mm visual analog scale (VAS), chewing efficiency via VAS, and anxiety using the Modified Dental Anxiety Scale (MDAS). Statistical analysis included repeated-measures ANOVA, paired t-tests, and multivariate regression.

Pain scores demonstrated significant reduction from 42.3 mm (±12.1) at 24 h to 3.1 mm (±2.8) at 30 days (F = 286.4, P < 0.001), with 92% achieving mild/no pain by 30 days. Chewing efficiency improved from 4.2 to 8.1 (mean - 3.9, P < 0.001; d = 1.2), while anxiety decreased from 14.7 to 8.3 MDAS (mean - 6.4, P < 0.001; d = 1.8). Regression analysis (R ² = 0.61) identified chewing improvement as the strongest satisfaction predictor (β = 0.42, P < 0.001), followed by negative associations with preoperative anxiety (β = -0.38, P < 0.001) and 48 h pain (β = -0.29, P < 0.001).

Successful RCT achieves significant, clinically meaningful improvements across pain, function, and psychological domains. The identified "triad of success" provides clinicians with evidence-based targets for optimizing patient care, emphasizing the importance of addressing both biological and psychosocial aspects of endodontic treatment.