Abstract
Purpose Postendodontic pain is one of the problems of root canal therapy. This clinical study aimed to evaluate the effect of infiltration injection of dexamethasone and methylprednisolone on postendodontic pain in patients with necrotic pulp. Methods A total of 80 volunteers with necrotic pulp teeth were included and assigned to two groups (n = 40). After the administration of local anesthesia and before root canal therapy, in group 1, an infiltration injection of 1 ml of dexamethasone was done and in group 2, an infiltration injection of 1 ml of methylprednisolone was done in the buccal vestibule of each tooth. Patients' pain was reported using a visual analogue scale at pretreatment and 6, 12, 24, and 48 hours after treatment. Results There was no significant difference between the two groups receiving dexamethasone and methylprednisolone at pretreatment and 6, 12, 24, and 48 hours after endodontic treatment. Conclusions Infiltration injection of dexamethasone and methylprednisolone had a significant effect in reducing pain after the endodontic treatment in necrotic pulp teeth, but between 6 and 12 hours, methylprednisolone had significantly more effect on pain relief than dexamethasone. Overall, the use of any of these drugs to reduce postendodontic pain is recommended.
Highlights
Despite the advances in root canal treatment, endodontic postoperative pain is common and can occur between 3% and 58% of patients depending on the variables: host-related factors, such as patient’s age, gender, tooth type, psychological and immunological factors; the iatrogenic factors, such as over instrumentation and chemical or obturating material; and the microbial factors
Studies by Yavari et al [12], Aksoy and Ege [13], Yousaf et al [14], and Naseri et al [15] on the effect of injection of corticosteroids on postendodontic pain in teeth with symptomatic irreversible pulpitis showed the effect of corticosteroids on decreasing pain after endodontic treatment
Because few studies have evaluated the effect of local infiltration of corticosteroids on postendodontic pain in necrotic teeth, the present study aimed to evaluate the efficacy of infiltration injection of dexamethasone and methylprednisolone on postendodontic pain in patients with necrotic pulp. e null hypothesis was that there is no difference in postendodontic pain in patients with necrotic pulp between dexamethasone and methylprednisolone
Summary
Despite the advances in root canal treatment, endodontic postoperative pain is common and can occur between 3% and 58% of patients depending on the variables: host-related factors, such as patient’s age, gender, tooth type, psychological and immunological factors; the iatrogenic factors, such as over instrumentation and chemical or obturating material; and the microbial factors. Some studies were done to evaluate the effect of corticosteroid on postendodontic pain in teeth with irreversible pulpitis. Studies by Yavari et al [12], Aksoy and Ege [13], Yousaf et al [14], and Naseri et al [15] on the effect of injection of corticosteroids on postendodontic pain in teeth with symptomatic irreversible pulpitis showed the effect of corticosteroids on decreasing pain after endodontic treatment. E study by Moradi et al on the efficacy of infiltration injection of dexamethasone on postendodontic pain of necrotic teeth showed infiltration administration of dexamethasone did not reduce postoperative pain severity in the first 12 hours after endodontic treatment [16]. Because few studies have evaluated the effect of local infiltration of corticosteroids on postendodontic pain in necrotic teeth, the present study aimed to evaluate the efficacy of infiltration injection of dexamethasone and methylprednisolone on postendodontic pain in patients with necrotic pulp. Because few studies have evaluated the effect of local infiltration of corticosteroids on postendodontic pain in necrotic teeth, the present study aimed to evaluate the efficacy of infiltration injection of dexamethasone and methylprednisolone on postendodontic pain in patients with necrotic pulp. e null hypothesis was that there is no difference in postendodontic pain in patients with necrotic pulp between dexamethasone and methylprednisolone
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