Authors: Torabinejad M, Kettering JD, McGraw JC, Cummings RR, Dwyer TG, Tobias TS.
Title: Factors associated with endodontic interappointment emergencies of teeth with necrotic pulps.
Journal: J Endod
Date: May 1988
Citation: 14(5):261-6
Category: Endodontic Emergencies
Evidence-based Ranking: 4
Purpose/Objectives: To investigate the effect of some factors contributing to interappointment emergencies (IAE).

Methods & Materials: The Information recorded in the charts of 2,000 patients was used for this study. Five geographically separate endodontic offices each provided clinical information on 400 teeth that required endodontic therapy performed within the last 3 yr. One-half of the patients were those who had interappointment pain or swelling which required a nonscheduled emergency visit for urgent care. The other half was patients who reported no complications after cleaning and shaping of their root canals. PatientsÂ’ age, sex, tooth type, presence or absence of systemic diseases, allergies, size of periapical radiolucency, and preoperative complaints were recorded and analyzed statistically.

Results/Conclusions: 1. Patients in the 40-59 yr range are more susceptible. 2. Female patients had more IAE than their male counterparts. 3. Mandibular bicuspids followed by the mandibular anteriors were the most problematic teeth after cleaning and shaping of their root canals. 4. Highly significant association exists between the frequency of IAE and the presence of allergies. 5. Patients with preoperative complaints are highly susceptible to IAE. 6. The frequency of IAE was significantly higher in patients with no or small periapical lesions than in those with larger lesions. 7. The patients who were taking medications postoperatively had significantly fewer IAE than those on no medications. 8. Retreated cases had a higher incidence of IAE than those that received initial treatments. 9. Presence of sinus tract significantly reduces the frequency of IAE. 10. Presence of systemic diseases, use of intracanal medication, and penetration of the foramen with small instruments had no significant effect on the frequency of IAE. ReviewerÂ’s Comments: Factors that may contribute to the occurrence of IAE.