Zakery James, Biraj Patel, Jianing He, Kenneth M Hargreaves, Nikita B Ruparel
{"title":"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。","authors":"Zakery James, Biraj Patel, Jianing He, Kenneth M Hargreaves, Nikita B Ruparel","doi":"10.1016/j.joen.2025.01.007","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.\"</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>The \"Gabapentin Pyramid Protocol\" represents an effective treatment option for persistent postendodontic pain, demonstrating significant symptom relief and potential for complete resolution.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Management of Persistent Post-Endodontic Pain With a Standardized Gabapentin Pyramid Protocol: A Case Series and Clinical Guidelines.\",\"authors\":\"Zakery James, Biraj Patel, Jianing He, Kenneth M Hargreaves, Nikita B Ruparel\",\"doi\":\"10.1016/j.joen.2025.01.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.\\\"</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>The \\\"Gabapentin Pyramid Protocol\\\" represents an effective treatment option for persistent postendodontic pain, demonstrating significant symptom relief and potential for complete resolution.</p>\",\"PeriodicalId\":15703,\"journal\":{\"name\":\"Journal of endodontics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-01-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of endodontics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.joen.2025.01.007\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of endodontics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.joen.2025.01.007","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Management of Persistent Post-Endodontic Pain With a Standardized Gabapentin Pyramid Protocol: A Case Series and Clinical Guidelines.
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.
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.