Does occlusal reduction reduce post‐endodontic pain? A systematic review and meta‐analysis.

Objectives: Pain management during endodontic therapy is an important issue in clinical practice. The objective of this systematic review and meta‐analysis was to evaluate the efficacy of occlusal reduction to control the post‐operative endodontic pain in adults undergoing root canal therapy. Materials and methods: Electronic database and manual searches of English papers were conducted up to August 2019 to identify randomised placebo‐controlled trials. The MeSH terms used were (endodontics OR root canal therapy) AND (postoperative pain) AND (occlusal reduction). The primary outcome measure was the post‐operative pain intensity up to 72 hours. Pooled standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using random‐effects inverse variance method. The statistical heterogeneity was assessed using the Cochrane Q test. The significance level was set at P <.05. Results: In total, six randomised controlled trials including 344 participants were included. Our meta‐analyses showed that relief of occlusal surface did not significantly reduce the pain intensity scores at 12‐ (SMD = −0.46; 95% CI = −1.24, 0.30; P =.239), 24‐ (SMD = −0.17; 95% CI = −0.73, 0.38; P =.533) and 48‐ (SMD = −0.67; 95% CI = −1.38, 0.03; P =.063) when compared to placebo. However, at 72 hours, patients received intervention showed significant more pain reduction than placebo groups (SMD = −1.07; 95% CI = −1.81, −0.32; P =.005). Conclusion: Based on this meta‐analysis, the efficacy of occlusal reduction in post‐endodontic pain control for up to 2 days is not supported. However, on day three, it had a positive influence on the control of post‐endodontic pain. [ABSTRACT FROM AUTHOR]