Pain Relief Effects and Safety of Transitional Therapy in the Treatment of Posterior Teeth of Pregnant Women with Symptomatic Irreversible Pulpitis and Symptomatic Apical Periodontitis

Purpose: To assess the pain relief effects and safety of transitional therapy (TT) in the treatment of posterior teeth of pregnant women with symptomatic irreversible pulpitis and symptomatic apical periodontitis.

Methods: A prospective cohort clinical study was conducted in the Department of Stomatology at Shenzhen Maternity & Child Healthcare Hospital, China, from January 2017 to December 2019. We enrolled 62 pregnant women with acute dental pain caused by posterior teeth with symptomatic irreversible pulpitis or symptomatic apical periodontitis. Among the 62 participants, 34 received TT, and 28 chose nontreatment during pregnancy. We evaluated the pain relief with the verbal numerical rating scale (VNRS) scores of pain perception in the clinical study, as well as the anti-bacterial medicament filling conditions of canals of in vitro models. Moreover, we investigated the safety outcomes, such as gestational age, neonatal head circumstance, birth weight, and body length.

Results: The VNRS scores of the participants treated with TT were significantly lower than those of the nontreatment group 2 days after treatment (P<0.001). TT treated pregnant women experienced significantly more pain decreases in VNRS scores than their counterparts(P<0.05). The optimal anti-bacterial medicament filling conditions of canals of in vitro models by TT method were comparable with those of canals instrumented with traditional RCT method. Moreover, no significant differences of safety outcomes were observed between pregnant women of these two groups.

Conclusion: The transitional therapy is efficient in alleviating acute dental pain of posterior teeth of pregnant women with symptomatic irreversible pulpitis and symptomatic apical periodontitis, and maintaining painless chains throughout pregnancy with no adverse effects on neonatal birth outcomes.