Postoperative pain after vital pulp therapy: A review of its characteristics and associated factors

Abstract

Background

Vital pulp therapy (VPT) is a contemporary approach for managing deep caries in permanent teeth. However, there is limited information about postoperative pain, especially in pediatric patients.

Objective

This comprehensive review examines English-language articles on postoperative pain after VPT, focusing on patient-reported discomfort from procedure completion to 7 days afterward. It aims to concisely summarize pain incidence, intensity, duration, analgesic usage, and associated factors.

Results

Diverse studies with different study designs, age groups, pulpal diagnoses, patient populations, VPT techniques, treatment protocols, and outcome measurements have examined postoperative pain after VPT. Significant heterogeneity exists among studies in the pain rating scale, timing of pain assessment, and reporting of pain incidence and intensity. None of the studies have examined postoperative pain after VPT as the primary outcome. The peak incidence of postoperative pain after VPT occurred on the first day, ranging from 26.8% to 79.1%. Patients commonly reported the pain as mild. This pain typically resolved within 7 days. Factors such as preoperative pain intensity, percussion pain, periapical lesions, and pulp dressing materials were identified as potential predictors for postoperative pain after VPT.

Conclusion

Understanding postoperative pain enhances clinicians’ proficiency, encouraging a more comprehensive, patient-centric VPT approach. This review fills a knowledge gap, offering valuable insights for practitioners. Recognizing the nuanced nature of pain dynamics allows clinicians to elevate their proficiency and provide optimal patient care with VPT. Future well-designed studies, focusing particularly on postoperative pain in children, will advance our understanding in this area.