A challenge: the management of pain

One of the main issues of modern endodontics is still represented by the management of pain. Endodontic pain is a controversial aspect since it is considered as a pre-operative diagnostic criterion, a possible consequence during multi-visits therapy as well as an important symptom of success of root canal treatment over time. In addition, the intensity of pain depends on several factors and does not necessarily reflect the pulp inflammation status. Indeed, endodontic flare-up is caused by chemical, microbial and mechanical agents, but there is also a correlation with age, gender, tooth element, number of appointments, use of intracanal medicaments, irrigants, shaping technique and pre-operative pain level. Considering all these variables, correct therapeutical strategies to prevent pain and diagnostic tool able to precisely identify the histopathological pulp status are strongly needed to guide and custom the treatment plan. Even pharmacological therapy and use of specific materials, such as calcium silicate- based cements, would seem to be fundamental to reduce inflammation and decrease pain.

It’s also been demonstrated how endodontic therapy may be associated to high level of fear and anxiety, that, on turn, worsen patient’s discomfort. The oral health perception is crucial since it may influence the general health status and patient’s quality of life. These aspects are of wide interest and are considered very current topics by international scientific community.

In the present issue, different important endodontic themes are developed such as use of irrigants with innovative protocols, advanced endodontic sealers and several treatment approaches with the aim to provide to clinicians various chances to obtain a long-lasting endodontic success.