Evidence map›Paper›PMID 41075433›Full record

ArticleJournal of dentistry2025

Prevalence and factors associated with severe pre-operative pain among patients presenting for non-surgical root canal treatment in the national dental PBRN PREDICT endodontic study.

Rahma Mungia, Ellen Funkhouser, Alan S Law, Donald R Nixdorf, Kimberly Lindquist, Dianne S Caprio, Jeffrey L Fellows, Gregg H Gilbert, National Dental PBRN Collaborative Group (The National Dental PBRN Collaborative Group comprises practitioners, faculty, and staff investigators who contributed to this network activity. A list of these persons is at;http://www.nationaldentalpbrn.org/collaborative-group.php)

Abstract read
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In one paragraph

Article in Journal of dentistry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Rahma MungiaDepartment of Periodontics, School of Dentistry, The University of Texas Health San Antonio, 8403 Floyd Curl Drive; MC 8258; Suite 300.29, San Antonio, TX 78229, US. Electronic address: mungia@uthscsa.edu.
Ellen FunkhouserDivision of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, 611 MT, Birmingham, AL 35294, US.
Alan S LawThe Dental Specialists, 2200 County Rd. C, West, Roseville, MN 55113, US; Division of Endodontics, University of Minnesota, US.
Donald R NixdorfDivision of TMD and Orofacial Pain, University of Minnesota, 6-320 Moos Tower, 515 Delaware Street S.E., Minneapolis, MN 55455, US.
Kimberly LindquistThe Dental Specialists Duluth, 324 West Superior Street, Suite 824, Duluth, MN 55802, US.
Dianne S CaprioDirector of Dentistry, Community Service Learning Center, School of Dental Medicine, East Carolina University, 100 Brunswick Medical Center Parkway, NE, Bolivia, NC 28422, US.
Jeffrey L FellowsKaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227, US.
Gregg H GilbertDepartment of Clinical & Community Sciences, School of Dentistry, University of Alabama at Birmingham, Medical Towers Suite 402, 1717 11th Avenue South, Birmingham, AL 35205, US.
National Dental PBRN Collaborative Group (The National Dental PBRN Collaborative Group comprises practitioners, faculty, and staff investigators who contributed to this network activity. A list of these persons is at;http://www.nationaldentalpbrn.org/collaborative-group.php)

Funding

The National Dental PBRNU19DE022516 · NIDCR · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GILBERT, GREGG H · 2012 to 2018
$66.4M
The National Dental PBRN - Administrative CoreU19DE028717 · NIDCR · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GILBERT, GREGG H · 2019 to 2025
$23.5M
Institute for Integration of Medicine & Science: A Partnership to Improve HealthUM1TR004538 · NCATS · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI ROBERT A CLARK, Kenneth M Hargreaves · 2023 to 2026
$22.3M
NCATS NIH HHS UM1 TR004538NIDCR NIH HHS U19 DE022516NIDCR NIH HHS U19 DE028717
6 · The paper itself

Abstract

backgroundThis study quantified severe pre-operative pain immediately prior to non-surgical root canal treatment (RCT) and identified associated factors among a large, diverse patient sample.

methodsThis National Dental Practice-Based Research Network study involved 153 practitioners recruiting 1,722 patients over six months. Patients rated their pain (0-10 scale) immediately prior to RCT; scores ≥7 were classified as severe. Associations between severe pain and demographics, medications, temporomandibular disorders (TMD), psycho-social factors, and clinical assessments were analyzed using generalized estimating equations, accounting for practitioner clustering.

resultsAmong 1,722 patients, mean current pain was 3.4 (sd=3.1); 21 % of patients reported severe pain at the time of RCT. Four characteristics were associated with increased likelihood of severe tooth pain, in order of magnitude: any of the 4 diagnostic findings (sensitivities) (OR=5.49, p<.001); patient taking pain medications for the tooth in the 7 days prior to RCT (OR=3.52, p<.001); pain catrastrophizing score of 5 or greater (OR=2.85; p<.001); and screening positive for TMD (OR=1.53; p=.006). Radiolucency was the only characteristic significantly (p<.05) inversely associated with severe tooth pain at the time of RCT (OR=0.73, p=.04) in the full multiple regression model.

conclusionSevere pre-operative pain is prevalent among RCT patients and apparently influenced by specific psychological and clinical factors. PRACTICAL IMPLICATIONS: Identifying predictors like catastrophizing and tooth sensitivity can help guide pre-treatment counseling and pain management to improve patient outcomes.

Indexed as

Root Canal TherapyToothacheAdultAgedFemaleHumansMaleMiddle AgedPain MeasurementPreoperative PeriodPrevalenceRisk FactorsTemporomandibular Joint DisordersUnited StatesYoung AdultEndodonticsPain measuresPsycho-social assessmentsRoot canal treatment

Identifiers

PMID41075433
PMCPMC12793975

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.