ABSTRACT Aim To compare post‐operative pain following root canal treatment (RCT) in HIV‐positive patients receiving highly active antiretroviral therapy (HAART) and HIV‐negative patients and to assess the influence of systemic condition on endodontic pain. Methodology This investigation was designed as a prospective observational cohort study, following the PROBE 2023 guidance. A total of 60 patients (30 HIV‐positive under HAART for at least three years with undetectable viral load, and 30 HIV‐negative) with pulp necrosis and asymptomatic apical periodontitis were included. All teeth were treated in a single visit by an endodontic specialist using standardised chemo‐mechanical preparation with reciprocating instruments, irrigation with 2.5% sodium hypochlorite and 17% EDTA, and single‐cone obturation with AH Plus sealer. Patients without preoperative pain (VAS = 0) were included. Post‐operative pain was assessed using a VAS, 0–10 at 6, 12, 24, 48 and 72 h and 7 days post‐treatment. Statistical analysis was performed using the chi‐square test, Kolmogorov–Smirnov test, and Mann–Whitney U test (95% confidence level). Results No significant differences were found between groups regarding sex, age or tooth location ( p > 0.05). Both groups reported postoperative pain in the first 24 h, with no significant differences ( p > 0.05). At 48 h, however, all HIV‐positive patients reported complete pain relief, whereas the HIV‐negative group still presented residual pain, showing a statistically significant difference ( p = 0.021). At 72 h and 7 days, both groups reported no pain (VAS = 0). Overall, postoperative pain prevalence exceeded 45% in the first 24 h, regardless of systemic condition. Conclusions Postoperative pain patterns were similar in HIV‐positive patients under HAART and HIV‐negative individuals, except for earlier pain resolution in the HIV‐positive group at 48 h. These findings suggest that the systemic condition does not negatively affect the short‐term management of endodontic pain.
Nuñovero et al. (Wed,) studied this question.