COMPARING PAIN PERCEPTION AND CERVICAL MUSCLE TENDERNESS FOLLOWING DIFFERENT DENTAL PROCEDURES: A MULTI-DEPARTMENT RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Dental treatments frequently cause varying degrees of postoperative discomfort, affecting patient satisfaction and treatment outcomes. Beyond localized oral pain, prolonged mouth opening, altered jaw positioning, and muscular strain during dental procedures can precipitate tenderness of the cervical musculature. While postoperative pain following individual dental procedures has been studied extensively, comparative evidence across dental specialties regarding both pain perception and cervical muscle tenderness remains limited. This randomized controlled trial aimed to determine whether significant differences exist in postoperative pain perception and cervical muscle tenderness among patients undergoing endodontic treatment, surgical extraction, and scaling and root planing (SRP). Methods: A multi-department RCT was conducted in 120 adult patients randomly allocated to six groups corresponding to participating departments: Orthodontics (n=20), Oral and Maxillofacial Surgery (n=20), Microbiology (n=20), Public Health Dentistry (n=20), Periodontology (n=20), and Oral Medicine and Radiology (n=20). Pain intensity was assessed using the Visual Analog Scale (VAS), and cervical muscle tenderness was evaluated by standardized bilateral palpation. Assessments were conducted at baseline, 24 hours, 72 hours, and 7 days postoperatively. Repeated measures ANOVA and Bonferroni post-hoc tests were applied, with significance set at p<0.05. Results: Significant intergroup differences were observed in pain perception and cervical muscle tenderness at all postoperative intervals (p<0.001). Patients from the Department of Oral and Maxillofacial Surgery yielded the highest mean VAS scores (6.8±1.5 at 24h), followed by Orthodontics (4.6±1.3), Oral Medicine and Radiology (4.2±1.2), Microbiology (3.5±1.1), Periodontology (2.7±0.9), and Public Health Dentistry (2.4±0.8). Cervical muscle tenderness followed the same trend, with the extraction group consistently exhibiting the highest scores. Both outcomes declined progressively over time in all groups. Conclusion: Surgical extraction was associated with the greatest postoperative pain and cervical muscle tenderness, while SRP demonstrated the lowest symptom burden. Awareness of procedure-specific musculoskeletal responses can facilitate individualized pain management and improve patient-centred care.