Migraine is Associated With Altered Preoperative Endodontic Pain Perception and Mechanical Sensory Function but Not Short‐Term Postoperative Pain: A Prospective Clinical Study

BACKGROUND: Migraine has been associated with altered nociceptive processing and may influence the clinical presentation of odontogenic pain. This study evaluated whether migraine is associated with preoperative endodontic pain, somatosensory function, and short-term pain outcomes after root canal treatment. METHODS: In this prospective observational study, 72 patients with symptomatic irreversible pulpitis requiring nonsurgical root canal treatment were classified into two groups: patients with neurologist-confirmed migraine assessed during the interictal phase and patients without migraine. The primary outcome was preoperative pain intensity, assessed using a 0-10 visual analogue scale (VAS). Additional secondary outcomes included mechanical detection threshold (MDT), mechanical pain threshold (MPT), mechanical pain sensitivity (MPS), pain during cold testing and needle penetration, and post-endodontic pain recorded at 6, 12, 24, 48, and 72 h. MDT, MPT, and MPS were assessed at the dorsal hand as an extracephalic reference site. RESULTS: Patients with migraine with endodontic pain reported significantly greater preoperative endodontic pain than those without migraine (VAS: 6.39 ± 2.04 vs. 4.20 ± 2.88; p = 0.0005). Secondary analyses showed MDT was significantly higher in the migraine group before and after treatment (p < 0.01), suggesting altered mechanical detection. MPT, MPS, Pain test score, Needle penetration Pain and short-term post-endodontic pain did not differ significantly between groups. CONCLUSIONS: Migraine patients with endodontic pain exhibited higher preoperative endodontic pain severity and elevated mechanical detection thresholds (MDT) compared to non-migraine patients, whereas other sensory measures (MPT, MPS) showed no significant differences. These findings suggest selective alterations in pain perception and tactile sensitivity in migraine patients, rather than a broad generalised sensory abnormality.