Secondary thermal hyperalgesia resulting from pulpal inflamm
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Inflammation can lead to hyperalgesia and allodynia by activation or sensitization of peripheral and central nervous system neurons. The cold test shows hypersensitivity in pulpal inflammation along with an exaggerated response of the adjacent sound tooth and the same tooth in the opposite jaw.

This study by the Journal of Endodontics was aimed to assess the occurrence of secondary thermal hyperalgesia in patients with symptomatic irreversible pulpitis (SIP).

The cold sensitivity test (Visual analog scale) was performed for the tooth with SIP (SIP group), its adjacent sound tooth (ADJ group), the same sound tooth in the opposite jaw (OPP group), and the contralateral sound tooth in the opposite quadrant of the same jaw (CONT group). Next, the tooth with SIP underwent root canal treatment and 3 weeks later, after complete elimination of pain, the teeth underwent cold sensitivity test again.

A total of 64 patients including 41 females and 23 males between 18-65 years were evaluated in this study. The response to the cold sensitivity test significantly decreased in SIP, ADJ, and OPP groups but not in the CONT group after endodontic treatment. No significant difference was noted between males and females in the groups.

In conclusion, hypersensitivity to cold test due to pulpal inflammation can also result in an exaggerated response of the adjacent sound tooth and the same tooth in the opposite jaw to cold sensitivity test; these observations can be explained by the central and peripheral sensitization mechanisms.

Source: https://doi.org/10.1016/j.joen.2021.02.010
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