The Mid-Treatment Crisis

Endodontic flare-ups, often described as the mid-treatment crisis, remain one of the most challenging and distressing complications during root canal therapy. Characterized by the sudden onset of pain and/or swelling between treatment appointments, these events can compromise patient confidence and clinical outcomes. This comprehensive review critically explores the multifactorial etiology of endodontic flare-ups, including microbial, mechanical, chemical, and host-related factors. It synthesizes current evidence on incidence, risk assessment, pathophysiology, prevention strategies, and evidence-based management protocols. By integrating contemporary literature with clinical perspectives, this book aims to enhance the clinician's understanding of flare-ups and provide practical guidance for effective prevention and control. An essential resource for postgraduate students and practicing endodontists, it bridges theory and clinical decision-making in everyday endodontic practice.