Lisa A. McGuire

Frequency of persistent tooth pain after root canal therapy: a systematic review and meta-analysis

INTRODUCTION Little is known about the frequency of persistent pain after endodontic procedures even though pain is a core patient-oriented outcome. We estimated the frequency of persistent pain, regardless of etiology, after endodontic treatment. METHODS Persistent tooth pain was defined as pain present > or = 6 months after endodontic treatment. Endodontic procedures included in the review were pulpectomy, nonsurgical root canal treatment, surgical root canal treatment, and retreatment. Four databases were searched electronically complemented by hand searching. Two independent reviewers determined eligibility, abstracted data, and assessed study quality. A summary estimate of persistent all-cause tooth pain frequency was established by using a random-effects meta-analysis. Using subgroup analyses, we explored the influence of treatment approach (surgical/nonsurgical), longitudinal study design (prospective/retrospective), follow-up rate, follow-up duration, initial treatment versus retreatment, and quality of reporting (Strengthening the Reporting of Observational Studies in Epidemiology rankings) on the pain frequency estimate. RESULTS Of 770 articles retrieved and reviewed, 26 met inclusion criteria. A total of 5,777 teeth were enrolled, and 2,996 had follow-up information regarding pain status. We identified 168 teeth with pain and derived a frequency of 5.3% (95% confidence interval, 3.5%-7.2%, p < 0.001) for persistent all-cause tooth pain. High and statistically significant heterogeneity among studies (I2 = 80%) was present. In subgroup analysis, prospective studies had a higher pain frequency (7.6%) than retrospectives studies did (0.9%). Quality of study reporting was identified as the most influential reason for study heterogeneity. CONCLUSIONS The frequency of all-cause persistent tooth pain after endodontic procedures was estimated to be 5.3%, with higher report quality studies suggesting >7%.

Frequency of Nonodontogenic Pain after Endodontic Therapy: A Systematic Review and Meta-Analysis

INTRODUCTION Little is known about ill-defined pain that persists after endodontic procedures, including an estimate of the problems magnitude. We conducted a systematic review of prospective studies that reported the frequency of nonodontogenic pain in patients who had undergone endodontic procedures. METHODS Nonodontogenic pain was defined as dentoalveolar pain present for 6 months or more after endodontic treatment without evidence of dental pathology. Endodontic procedures reviewed were nonsurgical root canal treatment, retreatment, and surgical root canal treatment. Studies were searched in four databases electronically, complemented by hand searching. A summary estimate of nonodontogenic tooth pain frequency was derived using random-effects meta-analysis. RESULTS Of 770 articles retrieved and reviewed, 10 met inclusion criteria, and nine had data on both odontogenic and nonodontogenic causes of pain. A total of 3,343 teeth were enrolled within the included studies and 1,125 had follow-up information regarding pain status. We identified 48 teeth with nonodontogenic pain and estimated a 3.4% (95% confidence interval, 1.4%-5.5%) frequency of occurrence. In nine articles containing data regarding both odontogenic and nonodontogenic causes of tooth pain, 56% (44/78) of all cases were thought to have a nonodontogenic cause. CONCLUSIONS Nonodontogenic pain is not an uncommon outcome after root canal therapy and may represent half of all cases of persistent tooth pain. These findings have implications for the diagnosis and treatment of painful teeth that were previously root canal treated because therapy directed at the tooth in question would not be expected to resolve nonodontogenic pain.

Chronic Pain: Information Resources on the Internet

Chronic pain is pain that lasts longer than one month after onset or pain that recurs after onset of injury or illness. Millions of Americans suffer from chronic pain conditions, whether from diseases such as diabetes or HIV infection or as a result of injured nerves, bones, or other tissues. The socioeconomic burden of chronic pain is immense. Estimates of the economic impact alone from health care expenses, lost productivity, and lost wages are

Collaboration is Key

100 billion annually. This article provides a general overview of noncancer causes of chronic pain symptoms, conditions, disease burden, and treatments. Authoritative Web sites for chronic pain information and patient resources are included.

JCHI EDITOR'S SELECT SITES

Abstract Since 2014, the University of Minnesotas Bio-Medical Library and the Wangensteen Historical Library of Biology and Medicine have positioned themselves as a vital component of a brand-new Health Sciences Education Center, which will complete construction in early 2020. With an emphasis on collaboration through interprofessional education, the libraries took advantage of this planning period to clearly articulate a vision for how the libraries will advance teaching and learning in the new Center, prototype new spaces and services, and develop critical partnerships with units from across the Universitys Academic Health Center and the larger campus. This chapter describes the partnership model developed, and the new suite of space-enabled services created, offers strategies for success when cultivating and working with partners, and analyzes the impact, risks, and lessons learned.

Subject and source trends in the Star Tribune's coverage of the medical literature.

For each issue of the Journal of Consumer Health on the Internet, the editor will select one or more sites considered of such high quality they qualify as “core” sites for accessing health care information. The sites may be grouped by subject content or by source of information. The selection of a Web site as a JCHI Editor’s Select Site is very much a personal choice of the Column Editor. The decision is based on experience and usage of the Internet for finding health care information. Criteria for selection of each site include reputation of the producer/publisher of the site, stability of the site, ease of use, quality/accuracy of information, availability of links (quality of link selection, do they work), and frequency of updates. While users must always check for changes in URLs, a standard problem on the Internet, the sites selected have exhibited stability in providing long-term access to quality information. Information about each site will include a description of the content of the Web page, along with an evaluation of searchability of the site and a rating system, * = good, ** = very good, *** = excellent. Please note that only superior sites will be included as a Select Site. The main page of each site will be reproduced and URLs to bookmark will be noted. JCHI Editor’s Select Sites will be printed on two facing pages so that they may be photocopied onto one page for use next to the computer terminal (single copies only, please; for multiple copies, contact Haworth Press). Suggestions for Web sites to include as JCHI Editor’s Select Sites are welcome. Lisa McGuire Bio-Medical Library University of Minnesota 505 Essex Street SE Minneapolis, MN 55455