Post-Operative Pain and Its Relationship with Patient-Related Factors after Vital Pulpotomy in Teeth with Symptomatic Pulpitis: A Prospective Clinical Study.

Abstract

Objective: Postoperative pain during endodontic treatment can impair patient comfort and complicate clinical management, particularly in symptomatic irreversible pulpitis. Vital pulpotomy treatment (VPT) is less invasive than total pulpectomy for symptomatic irreversible pulpitis.

Subject: This study aimed to evaluate postoperative pain in patients after VPT of permanent molars with symptomatic pulpitis and explore the relationship between postoperative pain and patient-related factors.

Methods: A total of 114 patients, aged 7-39, were included. Permanent molars (n = 114) with symptomatic irreversible pulpitis (periapical index ≤2) were selected. Preoperative pain levels, analgesic intake, and demographic data were recorded. All participants underwent a standardized pulpotomy procedure. Hemostasis was achieved within 5 min using a saline-embedded cotton pellet. A mineral trioxide aggregate was used as a pulpotomy agent, and the teeth were restored using a base of resin-modified glass ionomer, followed by composite restoration. Using a 4-point pain scale, the patients recorded their pain preoperatively before the administration of local anesthesia and postoperatively at 24 h, 72 h, and 1 week. Fisher's exact test was used to assess the relationships between categorical variables. Statistical significance was set at p < 0.05.

Results: Among the 114 patients, 110 (96.49%) had complete relief from preoperative pain after treatment, and no postoperative pain was recorded at 1 week, irrespective of patient-related factors, such as age, sex, and painkiller intake (95% CI: 0.529-0.554).

Conclusions: Vital pulpotomy is an effective treatment for relieving preoperative pain and preventing postoperative pain in teeth with symptomatic irreversible pulpitis independent of patient-related factors.