A number of causes may be associated with a flare-up of pain in a patient undergoing endodontic therapy.

Patient selection: status post root canal procedure


A flare-up may involve the pulp and/or periradicular tissues.


The most common cause is infection which may be due to:

(1) incomplete removal of the original infected material

(2) pushing infected material into the periapical region

(3) secondary infection after the procedure


Less common causes:

(1) chemical injury (irrigation solutions, root fillings, intracanal drugs, etc)

(2) mechanical trauma

(3) hyperalgesia

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