Abstract

Objective: The aim of the present study was to evaluate the effect of using a preoperative, single oral dose of dexamethasone versus placebo on postoperative pain and success of inferior alveolar nerve block in mandibular molars with symptomatic irreversible pulpitis.

Methods: Thirty two patients were randomly assigned into two equal groups. Patients were asked to record his/her pain level before starting the endodontic treatment using the [Numerical Rating Scale (NRS)]. Half an hour after oral administration of the tablets, the tooth was anaesthetized by inferior alveolar nerve block. They were instructed to make a mark on the point that was representing their pain level and to complete a pain diary at access cavity, pulp extirpation, immediately after treatment completion, 6, 12, 24 and 48 hours after the commencement of treatment.

Results: Results showed that either pre-operatively, at access, at pulp extirpation, post-operatively, after 6, 12, 24 as well as 48 hours; there was no statistically significant difference between the two groups.

Conclusion: Within the limitation of this study, it could be concluded that preoperative administration of a single dose of 0.5 mg dexamethasone did not seem to affect the intensity of postoperative pain or the anesthetic success of inferior alveolar nerve block using 2% mepivacaine with 1:100,000 epinephrine for patients suffering from symptomatic irreversible pulpitis in mandibular molars.

Keywords: Pretreatment Dexamethasone; Placebo; Post-Endodontic Pain; Inferior Alveolar Nerve Block; Mandibular Molars

References

1. Smith E. “NSAIDS for managing post-operative endodontic pain in patients who present with pre-operative pain: A systematic review and meta-analysis (2016).
2. Keiser K and Hargreaves KM. “Building effective strategies for the management of endodontic pain”. Endodcopy Top 3 (2002): 93-105.
3. Mohan S., et al. “Management of Post Treatment Endodontic Pain”. Journal of Dental Sciences and Oral Rehabilitation (2013): 8-9.
4. Seymour RA., et al. “Post-operative dental pain and analgesic efficacy”. British Journal of Oral Surgery 21 (1983): 290-297.
5. Mohammadi Z., et al. “Pharmacological strategies to control post-operative endodontic pain”. Journal of Dental Research 2 (2008): 61-68.
6. Liesinger A., et al. “Effect of variable doses of dexamethasone on posttreatment endodontic pain”. Journal of Endodontics 1 (1993): 35-39.
7. Kissin I. “Preemptive Analgesia”. Journal of Anesthesiology 93 (2000):1138-1143.
8. Ianiro SR., et al. “The Effect of Preoperative Acetaminophen or a Combination of Acetaminophen and Ibuprofen on the Success of Inferior Alveolar Nerve Block for Teeth with Irreversible Pulpitis”. Journal of Endodontics 1 (2007): 11-14.
9. Renata CRodrigues and M Henrique A. “Infection control in retreatment cases: In Vivo Antibacterial effects of 2 instrumentation systems”. Journal of Endodontics 4 (2015): 1600-1605.
10. Shantiaee Y., et al. “Efficacy of preoperative ibuprofen and meloxicam on the success rate of inferior alveolar nerve block for teeth with irreversible pulpitis”. International Dental Journal 67 (2017): 85-90.
11. El Mubarak AHH., et al. “Postoperative pain in multiple-visit and single-visit root canal treatment”. Journal of Endodontics 36 (2018): 36-39.
12. Ramamoorthi S., et al. “Comparative evaluation of postoperative pain after using endodontic needle and Endo Activator during root canal irrigation: A randomised controlled trial”. Australian Endodontic Journal (2015): 1-10.
13. Siqueira JF., et al. “Chemomechanical reduction of the bacterial population in the root canal after instrumentation and Irrigation with 1%, 2.5%, and 5.25% Sodium Hypochlorite”. Journal of Endodontics 26 (2000): 331-334.
14. Ali S., et al. “Prevalence of and factors affecting post-obturation pain following single visit root canal treatment in Indian population: A prospective, randomized clinical trial”. Journal of Contemporary Clinical Dentistry 3 (2012): 459.
15. Yoldas O., et al. “Postoperative pain after endodontic retreatment : Single- versus two-visit treatment”. Journal of Endodontics 98 (2004): 483-487.
16. Shibu TM. “Post operative pain in endodontics: A systemic review”. Journal of Dentistry and Oral Hygiene 7 (2015): 130-137.
17. Su Y., et al. “Healing rate and post-obturation pain of single- versus multiple-visit endodontic treatment for infected root canals : A systematic review”. Journal of Endodontics 372 (2011): 125-132.
18. Praveen R., et al. “Comparative Evaluation of premedication with ketorolac and prednisolone on postendodontic pain: A Double-blind randomized controlled trial”. Journal of Endodontics 43 (2017): 667-673.
19. Remmers T., et al. “The Efficacy of intraflow intraosseous injection as a primary anesthesia technique”. Journal of Endodontics 34 (2008): 280-283.
20. Parirokh M and Abbott PV. “Various strategies for pain-free root canal treatment”. Iranian Endodontic Journal 9 (2013): 1-14.
21. Marshall JG. “Consideration of steroids for endodontic pain”. Endodontic Topics 3 (2002): 41-51.
22. Holte K and Kehlet H. “Perioperative single-dose glucocorticoid administration: Pathophysiologic effects and clinical implications”. Journal of the American College of Surgeons 195 (2002): 694-712.
23. Iranmanesh F., et al. “Effect of Corticosteroids on Pain Relief Following Root Canal Treatment : A Systematic Review”. Iranian Endodontic Journal 12 (2017): 123-130.
24. Maingret F., et al. “Inflammatory Mediators Increase Nav1.9 Current and Excitability in Nociceptors through a Coincident Detection Mechanism”. The Journal of General Physiology 131 (2008): 211-225.
25. Oleson M., et al. “Effect of Preoperative Ibuprofen on the Success of the Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis”. Journal of Endodontics 36 (2010): 379-382.
26. Wang C., et al. “Comparison of post-obturation pain experience following one-visit and two-visit root canal treatment on teeth with vital pulps : a randomized controlled trial”. International Endodontic Journal 43 (2010): 692-697.
27. Attar S., et al. “Evaluation of Pretreatment Analgesia and Endodontic Treatment for Postoperative Endodontic Pain”. Journal of Endodontics 34 (2008): 652-655.
28. Figini L., et al. “Single Versus Multiple Visits for Endodontic Treatment of Permanent Teeth: A Cochrane Systematic Review”. Journal of Endodontics 34 (2008): 1041-1047.
29. Chiang CY., et al. “NMDA Receptor Mechanisms Contribute to Neuroplasticity Induced in Caudalis Nociceptive Neurons by Tooth Pulp Stimulation”. Journal of Neurophysiology 80 (1998): 2621-2631.
30. Jorge-araújo ACA and Bortoluzzi MC. “Effect of Premedication with anti-inflammatory drugs on post-endodontic pain : A randomized Clinical Trial”. Brazilian Dental Journal 29 (2018): 254-260.
31. Sharma N., et al. “Effect of preoperative administration of steroid with different routes on post endodontic pain : A randomized placebo controlled clinical trial”. The Journal of Endodontics 27 (2015): 107-112.
32. Bidar M., et al. “Comparison of Effect of Oral Premedication with Ibuprofen or Dexamethasone on Anesthetic Efficacy of Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis: A Prospective, Randomized, Controlled, Double-blind Study”. The Bulletin of Tokyo Dental College Journal 58 (2017): 231-236.

Citation

Citation: Mai Mohamed Safei Eldin., et al. “A Comparative Assessment of the Effect of Pretreatment Dexamethasone Versus Placebo on Post-Endodontic Pain and Success of Inferior Alveolar Nerve Block in Mandibular Molars with Symptomatic Irreversible Pulpitis: A Blinded Randomized Clinical Trial Therapeutic Study”. Acta Scientific Dental Sciences 4.5 (2020): 60-66.

Copyright

Copyright: © 2020 Mai Mohamed Safei Eldin., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.