Restor Dent Endod.  2024 Aug;49(3):e31. 10.5395/rde.2024.49.e31.

Assessment of mechanical allodynia in healthy teeth adjacent and contralateral to endodontically diseased teeth: a clinical study

• Patankar VR
• Jain AK
• Rao RD
• Rao PR

• KMID: 2559744
• DOI: http://doi.org/10.5395/rde.2024.49.e31

Abstract

Objectives
The present study investigated the prevalence of mechanical allodynia (MA) in healthy teeth adjacent and contralateral to endodontically diseased teeth.
Materials and Methods
This cross-sectional study included 114 patients with symptomatic irreversible pulpitis and apical periodontitis in permanent mandibular first molars who possessed healthy teeth adjacent and contralateral to the endodontically diseased tooth. The mechanical sensitivity of the teeth was determined by percussion testing. The presence or absence of pain on percussion in the teeth adjacent and contralateral to the endodontically diseased tooth and the tooth distal to the contralateral symmetrical tooth was recorded according to coding criteria. The prevalence of MA was computed as a percentage, and binary logistic regression analysis was done. The Fisher exact test and Mann-Whitney U test were used for binary and ordinal data.
Results
Age and sex did not influence the prevalence of MA. An increased prevalence of MA was found in patients with higher levels of spontaneous pain (p < 0.001). The prevalence of allodynia was 57% in teeth adjacent to endodontically diseased teeth and 10.5% in teeth contralateral to endodontically diseased teeth. In addition, on the ipsilateral side, there were more painful sensations distal to the diseased tooth than mesially.
Conclusions
Despite being disease-free, teeth adjacent and contralateral to endodontically diseased teeth exhibited pain on percussion. There was a direct association between the severity of the patient’s pain and the presence of MA.

Keyword

Central sensitization; Mechanical allodynia; Molar; Pain; Periapical periodontitis; Pulpitis

Figure

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  Figure 1 Prevalence of ipsilateral and contralateral MA. (A) Graph representing the percentage of ipsilateral and contralateral MA. (B) Graph representing contralateral MA in individual codes (Y2, Y3, Y4). Refer to Table 1 for code criteria (Y2, Y3, Y4 and code 0, code 1).MA, mechanical allodynia.

• 

  Figure 2 Influence of age and sex on the prevalence of ipsilateral and contralateral MA. (A) Graph representing the influence of age on the prevalence of ipsilateral MA. (B) Graph representing the influence of age on the prevalence of contralateral MA. (C) Graph representing the influence of sex on the prevalence of ipsilateral MA (Y1). (D) Graph representing the influence of sex on the prevalence of contralateral MA (Y2, Y3, Y4). Refer to Table 1 for code criteria (Y1, Y2, Y3, Y4 and code 0, code 1).MA, mechanical allodynia; CI, confidence interval.

• 

  Figure 3 Influence of preoperative pain levels on prevalence of ipsilateral and contralateral MA. (A) Graph representing the association between preoperative pain and ipsilateral MA. (B) Graph representing the association between preoperative pain and contralateral MA. Refer to Table 1 for code criteria (code 0, code 1, Y1).VAS, visual analogue scale; MA, mechanical allodynia; CI, confidence interval.

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