Evidence map›Paper›PMID 41241301›Full record

ArticleJournal of dentistry2026

Occurrence and predictors of severe pain one week after root canal treatment: the national dental PBRN PREDICT endodontic study.

R Mungia, E Funkhouser, LawAS, D R Nixdorf, A Diogenes, D T Kopycka-Kedzierawski, D S Caprio, G H Gilbert, National Dental PBRN Collaborative Group

Abstract read
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In one paragraph

Article in Journal of dentistry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

R 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, USA. Electronic address: mungia@uthscsa.edu.
E FunkhouserDivision of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, 611 MT, Birmingham, Alabama 35294, USA. Electronic address: emfunk@uab.edu.
LawASThe Dental Specialists, 2200 County Rd. C, West, Roseville, MN 55113, USA; Division of Endodontics, University of Minnesota, USA. Electronic address: alaw@thedentalspecialists.com.
D R NixdorfDivision of TMD and Orofacial Pain, University of Minnesota, 6-320 Moos Tower, 515 Delaware Street S.E., Minneapolis, MN 55455, USA. Electronic address: nixdorf@umn.edu.
A DiogenesDepartment of Endodontics, The University of Texas Health at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229, USA. Electronic address: diogenes@uthscsa.edu.
D T Kopycka-KedzierawskiProfessor of Dentistry, University of Rochester Medical Center Eastman Institute for Oral Health, Node Director, Northeast Region National Dental PBRN, Director, EIOH Clinical and Translational Research Core 625 Elmowood Ave, Box 683, Rochester, NY 14620, USA. Electronic address: Dorota_KopyckaKedzierawski@urmc.rochester.edu.
D S CaprioDirector of Dentistry, Community Service Learning Center, School of Dental Medicine, East Carolina University, 100 Brunswick Medical Center Parkway, NE, Bolivia, NC 28422, USA. Electronic address: capriod14@ecu.edu.
G H GilbertNational Dental PBRN, Distinguished Professor and the James R. Rosen Endowed Chair of Dental Research, Department of Clinical & Community Sciences, School of Dentistry, University of Alabama at Birmingham, Medical Towers Suite 402, 1717 11th Avenue South, Birmingham, AL 35205, USA. Electronic address: ghg@uab.edu.
National Dental PBRN Collaborative Group

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
NIDCR NIH HHS U19 DE022516NIDCR NIH HHS U19 DE028717
6 · The paper itself

Abstract

objectiveRoot canal treatment (RCT) is effective at relieving dental pain for most patients, but a minority report severe pain during the early post-treatment period. This study aimed to quantify the occurrence of severe pain during the 1-week period after RCT among consecutive patients requiring RCT and to identify pre-operative and intra-operative predictors of post-RCT severe pain in the National Dental Practice-Based Research Network.

methodsThis prospective cohort study enrolled patients across 153 general and endodontic practices. Eligible adults undergoing RCT completed surveys before and 1 week after treatment. Severe post-RCT pain was defined as patient-reported worst pain ≥7 on a 0-10 scale in the prior 7 days. Demographic, clinical, procedural, and psychosocial characteristics were collected and analyzed using logistic regression with generalized estimating equations, accounting for clustering by practice.

resultsAmong 1,059 patients, mean worst pain scores declined significantly from 5.3 pre-RCT to 2.6 post-RCT (p<.001). However, 14% reported severe pain at 1 week. Female sex, severe pain at time of RCT, screening positive for temporomandibular disorders, diagnosis of fibromyalgia, and having taken pain medication for tooth pain in the 7 days prior to RCT, were each significantly associated with severe post-RCT pain. Neither age, tooth type, provider specialty status, or psychosocial characteristics were independently predictive. Presence of a draining sinus tract and use of over 5x magnification were protective.

conclusionOne in seven patients reported severe pain in the first week after RCT, primarily associated with pre-operative pain factors and patient sex, underscoring the value of targeted pain management for high-risk patients. CLINICAL SIGNIFICANCE: Despite overall pain reduction after RCT, 14% of patients experience severe pain at one week. Female sex, pre-existing pain, and certain comorbidities increase risk. Identifying these factors enables clinicians to implement anticipatory guidance and tailored pain management, improving outcomes and minimizing patient distress in vulnerable subgroups.

Indexed as

Postoperative PainRoot Canal TherapyAdultAgedFemaleHumansMaleMiddle AgedPain MeasurementProspective StudiesRisk FactorsSex FactorsUnited StatesYoung AdultEndodontic outcomesPostoperative painPractice-based researchPsychosocial predictorsRoot canal therapy

Identifiers

PMID41241301
PMCPMC12832124

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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.