Management Of Endodontic Pain Research Articles

Identifying The Superior Root Canal Irrigant Between Hydrogen Peroxide And Sodium Hypochlorite In Post Endodontic Pain Management

Place of Study: THQ Thal Hospital LayyahStudy Design: Randomized control trialDuration of Study: January 2022 to July 2022Methodology: 104 subjects were selected by non-probability non purposive sampling technique. Informed consent was taken from the patients and they were randomly allocated to 2 study groups i.e. Group A (Sodium Hypochlorite) and Group B (Hydrogen Peroxide). Mechanical preparation of root canals for the lower first molar was done in the first appointment. In Group A, a 2.5 % Sodium Hypochlorite (NaOCl) irrigant was used, while in Group B, a 3% Hydrogen Peroxide (H O ) irrigant was used. 2 The patients were followed up after 10 days. The frequency of endodontic pain on the follow-up visit was evaluated by Visual Analogue Scale (VAS). Statistical Package for Social Science (version 23.0) (SPSS) was used to analyze the data. The frequency of endodontic pain was compared between the study arms with a chi-square test.Results: A total of 104 participants were placed into 2 groups, 52 cases in each group. 56/104 (54.30%) were males while 48/104 (45.70%) were females. In Group “A” endodontic pain on 10-day follow-up visit was present in 18/52 (34.6%) patients, while in Group “B” endodontic pain on 10-day follow-up visits were present in 35/52 (68%) patients. By using the chi-square test it was observed that there was a significant association between groups and the presence of endodontic pain having p-value = 0.001Conclusion: Sodium Hypochlorite was much better than Hydrogen Peroxide in the management of endodontic pain in terms of incidence.

Comparison of Endodontic Pain observed with Sodium Hypochloride, Hydrogen peroxide and Norman Saline based Root canal irrigants

Objective: To compare frequency and intensity of endodontic pain with sodium hypochlorite, hydrogen peroxide and normal saline groups. Method:105 subjects were randomly allocated to 3 study arms. Group A (Sodium Hypochlorite), Group B (Hydrogen Peroxide) & Group C (Normal saline).Data regarding endodontic pain was recorded by asking the patient to mark on the Visual Analogue Scale (VAS) according to the severity of pain on the proforma provided. Results:The minimum Intensity of pain was 0 and maximum was 10 with mean and standard deviation were 3.43  3.576 VAS. Endodontic pain was present in 12/35 (34.3%), 24/35 (68.6%), 30/35 (85%) patients of Group’s A, B, C respectively. Significant difference between groups with respect to Intensity of pain (VAS) was shown by one-way ANOVA. For Group A the Intensity of pain (VAS) was 82.38  4.34 and for Group B, C the Intensity of pain (VAS) were 4.37  3.456 and 6.11  3.197 respectively. Conclusions:Sodium Hypochlorite was much better than Hydrogen peroxide and normal saline in the management of endodontic pain in terms of incidence and intensity.

COMBATING CHALLENGES TO MANAGE ENDODONTIC PAIN IN DENTAL PRACTICE

One of the most challenging and difficult task in clinical practice of an endodontist is to manage pain. Advancements in understanding of pain physiology and pharmacology have provided a key upon which quick decisions can be made for treatment of any endodontic case. Despite advancement in technology, patients perception and apprehension is till date considered as a standard to acknowledge the expertise of an endodontist when undergoing a routine endodontic therapy. The current article aims to reflect effective strategies of management of endodontic pain in pre-operative, operative and postoperative situations. In lieu of clinical relevance of this topic in day to day life of an endodontist the topic was also addressed as a scientific paper presentation in a national conference to welcome thoughts of colleagues at a broader platform.

Comparative Evaluation of the Efficacy of Intra-ligamentary Injection of 20 mg Piroxicam Versus 4% Articaine in Management of Endodontic Pain in Patients with Symptomatic Irreversible Pulpitis in Mandibular Molars: A Randomized Controlled Clinical Trail

Comparative Evaluation of the Efficacy of Intra-ligamentary Injection of 20 mg Piroxicam Versus 4% Articaine in Management of Endodontic Pain in Patients with Symptomatic Irreversible Pulpitis in Mandibular Molars: A Randomized Controlled Clinical Trail

A 3-Dimensional Approach in the Management of Endodontic Pain:A Review

Recent advances in the understanding of pain physiology and pharmacology have provided dental practitioners with more reliable information upon which clinical decisions in the treatment of endodontic pain can be based. One of the effective strategies currently used in these cases is structured to evaluate the painful condition through a 3-D approach which establishes a differential diagnosis, definitive treatment, and rational use of drugs, based on the most appropriate scientific evidence available in the literature. This article provides practical treatment strategies based upon current scientific evidence and uses information presented in the articles.

Comparative evaluation of the efficacy of diclofenac sodium administered using different delivery routes in the management of endodontic pain: A randomized controlled clinical trial

Introduction:Pain of endodontic origin is of concern to both the patient and the clinician. Expectation of a painful experience can increase the patient's anxiety levels, making treatment more difficult. Management of endodontic pain is one of the challenging aspects in endodontics.Objective:To evaluate whether the intraligamentary mode of administration of diclogfenac sodium is effective in abating endodontic pain during interappointment visits.Aim:The purpose of this clinical trial is to evaluate the analgesic efficacy of diclofenac sodium administered through oral and intraligamentary routes in reducing postendodontic pain.Materials and Methods:Thirty patients were randomly allocated into three groups. Group A – placebo (Vitamin B12), Group B – diclofenac sodium (intraligamentary), and Group C – diclofenac sodium tablets. The tablets were given 30 min before the start of the procedure, while the intraligamentary injection was administered before commencing the endodontic procedure. The visual analog scale was used to evaluate the pain score at baseline and 6, 12, 24, and 48 h postoperatively.Results:Prophylactic intraligamentary injection of diclofenac sodium was found to be highly effective in reducing postendodontic pain than the oral route of administration.Conclusion:In patients with low pain threshold, intraligamentary route of administration is effective in controlling pain of endodontic origin postoperatively.

Evaluation of Functional GABA B Receptors in Dental Pulp

Gamma-aminobutyric acid (GABA) is an inhibitory neurotransmitter that is elevated in inflamed human dental pulp. Because GABA agonists are antihyperalgesic in other tissue, it is possible that GABA agonists have similar effects in dental pulp assuming that this tissue contains GABA receptors. We tested the hypothesis that dental pulp contains functional GABA(B) receptors using a GTPgamma35S binding assay. This is a functional assay because GTPgamma35S will be bound to cell membranes only when activation of metabotropic receptors has lead to binding and activation of their associated G(alpha)-proteins via release of GDP and binding of the GTPgamma35S. Baclofen, a GABA(B) agonist, evoked GTPgamma35S binding in both human and bovine dental pulp. This was mediated by the GABA(B) receptor because it was blocked by the selective antagonist phaclofen in both tissues. The presence of GABA and its receptor, GABA(B), suggests that this system may be relevant in the production or management of endodontic pain.

Management of endodontic pain with nonsteroidal anti-inflammatory agents: A double-blind, placebo-controlled study

The ability of two nonsteroidal anti-inflammatory agents—piroxicam and diclofenac—to control endodontic pain was compared with that of a placebo control in a double-blind study of 267 patients requiring endodontic therapy. Endodontic treatment was carried out over three visits with an interval of 5 to 7 days between each two consecutive visits. All patients were clearly instructed to take the medication only if they experienced pain, between the visits or postoperatively, for 3 consecutive days. The patients subjectively rated their pain on a scale of 1 to 4 as none, mild, moderate, or severe. The ratings were done preoperatively and at 2, 4, and 8 hours after the initial dose of medication was taken, as well as on the second and third days. Statistical analysis of the data revealed that both piroxicam and diclofenac significantly reduced the mean pain score at the end of all observations and were significantly superior to the placebo until the end of the study. More than 90% of the patients treated with piroxicam and more than 80% of the patients treated with diclofenac showed complete relief of pain. Overall, piroxicam was clearly more effective than diclofenac or the placebo. It provided more consistent relief of pain, beginning 2 hours after the initial dose, and it continued to do so at every interval thereafter. Diclofenac required longer time to reach maximum effectiveness. Piroxicam's superiority was greater at the first and second days after the initial dose of medication was taken. With respect to side effects, piroxicam was better tolerated by the patients. However, the mild side effects that were reported by the patients during the short-term use of both medications are unlikely to produce harmful results. Therefore, none of the prescribed medications was discontinued.