Reliability of Clinical Examination Methods for Pain in Periapical Periodontitis

Abstract

Abstract Objectives: This study aimed to compare pain intensity levels of a tooth at rest and in function, and percussion and chewingtests to verify a reliable clinical test method. Materials and Methods: A total of 36 asymptomatic necrotic teeth that required root canal treatment, one in each patient, were included. The entire treatment procedure was performed during a single visit by an experienced endodontist. Patients were asked to mark their pain levels on a vertical visual analog scale (VAS) while the relevant tooth was at rest and during function 24 h after the treatment. In addition, patients were asked to mark their pain levels on the same VAS after the clinical tests of percussion and chewing. Finally, the pain levels were compared using Pearson’s correlation for the reliability of the test methods at a significance level of 95%. Results: The postoperative pain levels measured during the clinical tests and functions were significantly higher than the pain levels at rest (p<0.05). The pain levels by percussion were significantly higher than that during the function and chewing tests (p<0.05). Pain intensity during the function was simulated with a higher correlation using the chewing strip method rather than the percussion method. Conclusions: According to this study, a bite test using chewing strips as a pain intensity assessment can mimic the actual postoperative pain experience, whereas percussion tests fail. Clinical relevance: The pain intensity levels determined by the bite test using chewing strips may provide reliable clinical signs similar to actual pain levels.