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Assessment of factors influencing post-operative pain: the impact of smoking habit in root canal treatments obturated with carrier-based technique and epoxy resin sealer

Giornale Italiano di Endodonzia, ISSN: 1971-1425, Vol: 38, Issue: 3, Page: 8-16
2024
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Aim: To confirm predictive factors of post-operative pain (PP) and to further explore if smoking habit may influence the incidence, intensity and evolution of PP. Methodology: Two hundred forty-five consecutive patients requiring endodontic treatment were included and pre-operative, patient and tooth-related factors were recorded. Patients were divided in 3 categories depending on smoking habit: non-smokers/light-smokers (<10 cigarettes/day)/heavy-smokers ( cigarettes/day). Questionnaires recorded presence and intensity of post-instrumentation (PIP) and post-obturation pain (POP) in a 100 mm Visual Analogue Scale (VAS) at 24,48,72 hours (h), 7 days (d). Linear regression analysis determined the patient-, tooth- and treatment-related factors influencing intensity of PIP and POP at 24, 48, 72h, 7d after treatment. Logistic regression was used to assess variables influencing incidence of PP and need of painkillers. Linear-by-linear association test was used to assess differences in trend of intensity of PP among non-, light- and heavy-smokers at different time points. Results: Two hundred twenty-three patients returned the questionaries. Incidence and intensity of POP were influenced by: patient-related (smoking habit, gender), tooth-related (endodontic status, size of periapical lesions), treatment-related factors (obturation quality). Heavy-smokers showed significantly higher incidence of POP (p<0.03) both 24 and 48h after treatment (OR=4.33, 95% CI 1.13-16.58 and OR=6.22, 95% CI 1.14-27.36 respectively). Different factors affected incidence and intensity of PIP/POP. Heavy-smokers had a higher incidence of PP than light and non-smokers. Smoking habit influenced intensity of POP during the first 48h after treatment. Conclusions: Heavy smoking habit can adversely influence the intensity of post-obturation pain during the first hours after root canal treatment.

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