Innovations in Innervations: A Pain Saga – Ep. 66
In this episode, Dr. Jennifer Gibbs enthusiastically delves into the complex dynamics of persistent pain after endodontic treatment. She highlights the challenges in addressing biofilm, particularly in intricate root anatomy where conventional cleaning methods fall short. Dr. Gibbs emphasizes the need for advanced irrigation techniques to better clear biofilm, which could reduce postoperative pain, though she acknowledges the current lack of robust patient-centered outcomes in research. She reflects on the limitations in existing diagnostic tools and expresses hope for future technologies that could offer more precision in detecting persistent infections. The mention of biomarkers and AI-powered technologies excites her, as Dr. Gibbs notes, they hold the promise of “precision endodontics”—allowing practitioners to better identify pathological processes. While Dr. Gibbs recognizes some endodontists may fear a reduction in root canal procedures with more precise diagnostics, she sees it as an opportunity to offer more accurate treatment and improve patient outcomes.
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Episode Resources
- De Armas, V., Erdogan, O., Yoon, H., Abdennour, M., & Gibbs, J. L. (2022). Contribution of endodontic pathology to persistent orofacial pain: a case report. Journal of endodontics, 48(9), 1178-1184. https://www.jendodon.com/article/S0099-2399(22)00433-2/abstract
- Erdogan, O., Malek, M., & Gibbs, J. L. (2021). Associations between pain severity, clinical findings, and endodontic disease: a cross-sectional study. Journal of endodontics, 47(9), 1376-1382. https://www.jendodon.com/article/S0099-2399(21)00479-9/abstract
- Vena, D. A., Collie, D., Wu, H., Gibbs, J. L., Broder, H. L., Curro, F. A., ... & PEARL Network Group. (2014). Prevalence of persistent pain 3 to 5 years post primary root canal therapy and its impact on Oral health–related quality of life: PEARL network findings. Journal of endodontics, 40(12), 1917-1921. https://www.jendodon.com/article/S0099-2399(14)00706-7/abstract
- Benjamin, P. (2011). Pain after routine endodontic therapy may not have originated from the treated tooth: A critical summary of Nixdorf DR, Moana-Filho EJ, Law AS, McGuire LA, Hodges JS, John MT. Frequency of nonodontogenic pain after endodontic therapy: a systematic review and meta-analysis. J Endod 2010; 36 (9): 1494–1498. The Journal of the American Dental Association, 142(12), 1383-1384. https://www.sciencedirect.com/science/article/abs/pii/S0002817714627677
- Signor, B., Kopper, P. M. P., Aspesi, M., Münchow, E. A., & Scarparo, R. K. (2024). Postoperative pain after single-visit root canal treatment or vital pulp therapy: A systematic review and meta-analysis. The Journal of the American Dental Association, 155(2), 118-137. https://www.sciencedirect.com/science/article/abs/pii/S0002817723006852
- Gibbs, Jennifer & Urban, Rochelle & Basbaum, Allan. (2013). Paradoxical surrogate markers of dental injury-induced pain in the mouse. Pain. 154. 10.1016/j.pain.2013.04.018.