Abstract

This clinical study was conducted to compare between intra-ligamentary injection of 20 mg Piroxicam and 4% Articaine after inferior alveolar nerve block injection in patients with symptomatic irreversible pulpitis of mandibular molar teeth treated in a single-visit root canal treatment as regards to their ability to control pain during access cavity preparation, instrumentation and at 6, 12, 24, 48-hrs post-operatively using Numerical Rating Scale (NRS).

The study design was a double blinded randomized clinical trial as study participants and assessor didn’t know which intervention has been received. Twenty patients complaining from symptomatic irreversible pulpitis in posterior mandibular teeth were included. After thoroughly careful clinical and radiographic examination, patients were randomly assigned into two equal groups (n=10) Group P, where patients received intra-ligamentary 20 mg Piroxicam, or Group A, where patients received intra-ligamentary 4% Articaine. Root canal treatment was performed in single-visit using RaCe Rotary NiTi files, then Obturation was then done using modified single cone technique with resin sealer.

Pain was assessed pre-operatively, during access cavity preparation, instrumentation, at 6, 12, 24 and 48-hrs post-operatively, in addition the need of supplemental anesthesia and post-operative analgesic intake were recorded.

Results showed similarity between the two groups regarding age, gender distribution, tooth type and pre-operative pain, there was significant reduction in pain in both groups, however, there was statistically significant reduction in post-operative pain intensity in the Piroxicam group during instrumentation and at 6, 12 and 24-hrs compared to the Articaine group, however there was no statistically significant difference between the two groups at 48-hrs post-operatively. Moreover, there was significant increase in pain with the Articaine group during instrumentation.

There was also a statistically significant difference between the two groups regarding the supplemental intra-pulpal anesthesia and post-operative analgesic intake, where the Articaine group showed higher percentage of the needed supplemental intra-pulpal anesthesia and post-operative analgesic intake.

It could be concluded that: Intraligamentary injection of Piroxicam showed a significant success in reducing intra and post-operative pain compared to Articaine. Articaine can be used as a successful supplemental technique during early stages of treatment.

Keywords: Piroxicam; Articaine; Intra-Ligamentary Injection; Post-Operative Endodontic Pain; Mandibular Molars

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Citation

Citation: Lobna Mohamed Hassan Elhaddad., et al. “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”. Acta Scientific Dental Sciences 5.10 (2021):.

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Copyright: © 2021 Lobna Mohamed Hassan Elhaddad., 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.