THE EFFECT OF OCCLUSAL REDUCTION ON PAIN AFTER ENDODONTIC INSTRUMENTATION

One hundred seventeen patients with posterior teeth requiring endodont ic treatment were studied. Specific clinical findings were recorded, i ncluding pulp vitality, preoperative pain, sensitivity to percussion, and the presence of a periradicular radiolucency. Excluded from the st udy were teeth with restorations to be maintained, greater than class I restorations to be maintained, greater than class I mobility, pocket depths >5 mm, endodontic retreatments, and patients taking pain alter ing medications. Teeth were randomly assigned to 1 of 3 groups: (i) to tal occlusal reduction, (ii) simulated occlusal reduction (nonfunction al cusp reduction), or (iii) control (occlusion untouched). After cana l instrumentation, a questionnaire was used by patients to record pain responses over a 48-h postoperative period. Responses were tabulated using a chi(2) test (p = <0.05), and a statistically valid profile of patients most likely to benefit from occlusal reduction was developed. Occlusal reduction should prevent postoperative pain in those patient s whose teeth initially exhibit pulp vitality, percussion sensitivity, preoperative pain, and/or the absence of a periradicular radiolucency .