Management of Persistent Post-Endodontic Pain With a Standardized Gabapentin Pyramid Protocol: A Case Series and Clinical Guidelines.

IF 3.5 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Zakery James, Biraj Patel, Jianing He, Kenneth M Hargreaves, Nikita B Ruparel
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引用次数: 0

Abstract

Introduction: Persistent postendodontic pain following endodontic therapy is a rare but substantial clinical challenge. Mechanisms that mediate peripheral neuropathy and/or central sensitization likely play a pivotal role in its development and chronification. The objective of this case series is to describe a management plan for persistent postendodontic pain and provide prescription guidelines using a standardized "Gabapentin Pyramid Protocol" for clinical practice.

Methods: Four cases of persistent postendodontic pain are presented. A peripheral etiology for pain was eliminated in all 4 cases. All patients were also refractory to conventional analgesics. Patients received the "Gabapentin Pyramid Protocol."

Results: Three of the 4 cases experienced complete resolution of symptoms within the prescribed treatment period. In 1 case, symptoms were greatly reduced but recurred upon discontinuation of the drug.

Conclusions: The "Gabapentin Pyramid Protocol" represents an effective treatment option for persistent postendodontic pain, demonstrating significant symptom relief and potential for complete resolution.

用标准加巴喷丁金字塔方案治疗慢性牙髓后疼痛:一个病例系列和临床指南。
牙髓治疗后持续的牙髓后疼痛是一种罕见但实质性的临床挑战。介导周围神经病变和/或中枢致敏的机制可能在其发展和慢性化中起关键作用。本病例系列的目的是描述持续性牙髓后疼痛的管理计划,并为临床实践提供使用标准化的“加巴喷丁金字塔方案”的处方指南。方法:对4例持续性牙髓后疼痛患者进行分析。所有4例均排除了疼痛的外周病因。所有患者对常规镇痛药也均难治。患者接受“加巴喷丁金字塔方案”。结果:4例患者中有3例在规定的治疗期内症状完全缓解。在一个病例中,症状大大减轻,但停药后又复发。结论:“加巴喷丁金字塔方案”是治疗持续性牙髓后疼痛的有效选择,表现出明显的症状缓解和完全解决的潜力。
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来源期刊
Journal of endodontics
Journal of endodontics 医学-牙科与口腔外科
CiteScore
8.80
自引率
9.50%
发文量
224
审稿时长
42 days
期刊介绍: The Journal of Endodontics, the official journal of the American Association of Endodontists, publishes scientific articles, case reports and comparison studies evaluating materials and methods of pulp conservation and endodontic treatment. Endodontists and general dentists can learn about new concepts in root canal treatment and the latest advances in techniques and instrumentation in the one journal that helps them keep pace with rapid changes in this field.
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