Acta Scientific Dental Sciences (ASDS)(ISSN: 2581-4893)

Research Article Volume 6 Issue 10

Post Operative Pain and Expression of Substance P, Il8 After the Use of Ketorolac Irrigant in Teeth with Symptomatic Irreversible Pulpitis with Apical Periodontitis (Clinical Trial)

Nasrin Salem Bazina1*, Geraldine Mohamed Ahmed2 and Olfat Gamil Shaker3

1Master Degree in Endodontics, Faculty of Dentistry, Cairo University, Egypt
2Professor of Endodontics, Faculty of Dentistry, Cairo University, Egypt
3Professor of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Egypt

*Corresponding Author: Nasrin Salem Bazina, Master Degree in Endodontics, Faculty of Dentistry, Cairo University, Egypt.

Received: September 02, 2022; Published: September 30, 2022

Abstract

Introduction: Endodontic post-treatment pain management is one of the most challenging problems in the clinical practice of endodontics. Although this pain is decreased after root canal treatment, there may be residual symptoms due to inflammation. It has been reported that up to 80% of patients with preoperative pain will report pain after endodontic treatment, which might range from mild to severe. Therefore, pain control is an important aspect of root canal treatment before, during and after intervention

Aim of the study: To assess the influence of ketorolac tromethamine versus sodium hypochlorite irrigant as a final rinse on, Postoperative pain in patients with symptomatic irreversible pulpitis with apical periodontitis in single visit root canal treatment and Periapical substance P and IL-8 level post- instrumentation and pre obturation.

Methods: Forty-four patients were included. After confirming the diagnosis clinically and radiographically, patients were assigned into two irrigant groups (n=22), 2.5% sodium hypochlorite and ketorolac tromethamine. The pain was assessed using the verbal rating scale (VRS) preoperatively, and postoperatively after 6, 12, 24 and 48 hours. All demographic, baseline and outcome data were collected and statistically analyzed. Periapical blood samples (sample 1) were collected on post instrumentation, and periapical blood samples (sample 2) were collected pre- obturation. Quantification of substance P and IL8 was done by ELISA test.

Results: There was no statistically significant difference between the two groups regarding age, gender distribution, pre-operative pain and post operative pain at 6 hours, 12 hours, 24 hours, 48hours. There was no statistically significant difference in the levels of IL8 and substance P between the two irrigant groups.

Conclusion: Sodium hypochlorite used as a root canal irrigant to reduce bacterial count could be contributed to the reduction in inflammation and postoperative pain. The level of IL8 and substance P showed no statistically significant difference between the two irrigant groups.

Keywords: Single Visit Root Canal Treatment; Irrigation; Ketorolac; Interleukin 8; Substance P

References

  1. Keiser K and Hargreaves “Building effective strategies for the management of endodontic pain”. Endodontic Topics 3.1 (2002): 93-105.
  2. Polycarpou N., et al. “Prevalence of persistent pain after endodontic treatment and factors affecting its occurrence in cases with complete radiographic healing”. International Endodontic Journal 3 (2005): 169-178.
  3. Nixdorf DR., et al. “Frequency of persistent tooth pain after root canal therapy: a systematic review and meta-analysis”. Journal of Endodontics 2 (2010): 224-230.
  4. Marshall JG and Walton RE. “The effect of intramuscular injection of steroid on posttreatment endodontic pain”. Journal of Endodontics 12 (1984): 584-588.
  5. Liesinger A., et al. “Effect of variable doses of dexamethasone on posttreatment endodontic pain”. Journal of Endodontics1 (1993): 35-39.
  6. Arora M., et al. “Effect of maintaining apical patency on endodontic pain in posterior teeth with pulp necrosis and apical periodontitis: a randomized controlled trial”. International Endodontic Journal4 (2016): 317-324.
  7. Mehrvarzfar P., et al. “Effect of supraperiosteal injection of dexamethasone on postoperative pain”. Australian Endodontic Journal1 (2008): 25-29.
  8. Shahi S., et al. “Effect of premedication with ibuprofen and dexamethasone on success rate of inferior alveolar nerve block for teeth with asymptomatic irreversible pulpitis: a randomized clinical trial”. Journal of Endodontics2 (2013): 160-162.
  9. Fedorowicz Z., et al. “Irrigants for non-surgical root canal treatment in mature permanent teeth”. Cochrane Database of Systematic Reviews 9 (2012): CD008948.
  10. Keskin C., et al. “Effect of intracanal cryotherapy on pain after single-visit root canal treatment”. Australian Endodontic Journal2 (2017): 83-88.
  11. Farzaneh S., et al. “Effect of two different concentrations of sodium hypochlorite on postoperative pain following single‐visit root canal treatment: a triple‐blind randomized clinical trial”. International Endodontic Journal 1 (2018): e2-e11.
  12. Rogers MJ., et al. “Comparison of effect of intracanal use of ketorolac tromethamine and dexamethasone with oral ibuprofen on post treatment endodontic pain”. Journal of Endodontics5 (1999): 381-384.
  13. Bamini L Anand , et al. “Influence of anti- inflammatory irrigant on substance P expression for single-visit root canal treatment of teeth with irreversible pulpitis”. Australian Endodontic Journal 46.1 (2020): 73-81.
  14. Alamassi BY. “Endodontic Postoperative Pain: Etiology and Related Factors - An Update 5.2 (2017): 13-21.
  15. Sathorn C., et al. “The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review”. International Endodontic Journal2 (2008): 91-99.
  16. Honore P and Jarvis MF. “Comprehensive Medicinal Chemistry II”. 2nd edition (2007): 327-349, Elsevier, St.
  17. Ferreira-Valente MA., et al. “Validity of four pain intensity rating scales”. Pain10 (2011): 2399-2404.
  18. Onay EO., et al. “The evaluation of endodontic flare-ups and their relationship to various risk factors”. BMC Oral Health1 (2015): 142.
  19. Priyank H., et al. “Assessment of the Incidence of Post treatment Endodontic Flare-ups in Patients undergoing Single-sitting Root Canal Therapies: A Clinical Study”. The Journal of Contemporary Dental Practice 10 (2016): 849-852.
  20. Singh S and Garg A. “Incidence of post-operative pain after single visit and multiple visit root canal treatment: A randomized controlled trial”. Journal of Conservative Dentistry 4 (2012): 323-327.
  21. Menke ER., et al. “The effectiveness of prophylactic etodolac on post endodontic pain”. Journal of Endodontics 12 (2000): 712-715.
  22. Mokhtari F., et al. “Effect of premedication with indomethacin and ibuprofen on postoperative endodontic pain: A clinical trial”. Iranian Endodontic Journal1 (2016): 57-62.
  23. Gilbert GH., et al. “Discordance between presumed standard of care and actual clinical practice: The example of rubber dam use during root canal treatment in the national dental practice-Based research network”. BMJ Open (2015): 5.
  24. Ravanshad , et al. “Effect of working length measurement by electronic apex locator or radiography on the adequacy of final working length: a randomized clinical trial”. Journal of Endodontics 36.11 (2010): 1753-1756.
  25. Herrera M., et al. “Critical diameter of apical foramen and of file size using the root ZX apex locator: An in vitro study”. Journal of Endodontics9 (2011): 1306-1309.
  26. Iqbal M., et al. “Incidence and factors related to flare-ups in a graduate endodontic programme”. International Endodontic Journal2 (2009): 99-104.
  27. El Khodary S and Roshdy N. “Influence of different rotary systems on the amount of apically extruded debris in mandibular molars (An In vitro study)”. EDJ2 (2019): 1663-1670.
  28. Chang YC., et al. “The effect of sodium hypochlorite and chlorhexidine on cultured human periodontal ligament cells”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 4 (2001): 446-450.
  29. Gomes-Filho JE., et al. “Comparison of the biocompatibility of different root canal irrigants”. Journal of Applied Oral Science 2 (2008): 137-144.
  30. Estrela CR., et al. “Mechanism of action of sodium hypochlorite”. Brazilian Dental Journal 2 (2002): 113-117.
  31. 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 Endodontics6 (2000): 331-334.
  32. Violich DR and Chandler NP. “The smear layer in endodontics - a review”. International Endodontic Journal 1 (2010): 2-15.
  33. Altundasar E., et al. “Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology 4 (2011): e31-e35.
  34. Yeter KY., et al. “Weight of apically extruded debris following use of two canal instrumentation techniques and two designs of irrigation needles”. International Endodontic Journal 9 (2013): 795-799.
  35. Evangelin J., et al. “Influence of different irrigants on substance P and IL-8 expression for single visit root canal treatment in acute irreversible pulpitis”. Australian Endodontic Journal 1 (2020): 17-25.
  36. Alonoso-Ezpeleta LO., et al. “Postoperative pain after one visit root canal treatment on teeth with vital pulps; comparison of three different obturation technique”. Medicina Oral, Patologia Oral y Cirugia Bucal 4 (2012): 721.
  37. Wong AWY., et al. “Incidence of post- obturation pain after single visit versus multiple visit non-surgical endodontic treatments”. BMC Oral Health1 (2015): 96.
  38. Adanir NCFK and Belli S. “Sealing Properties of Different Resin-Based Root Canal Sealers”. Journal of Biomedical Materials Research Part B: Applied Biomaterials 77B (2005): 1-4.
  39. Marciano MA., et al. “Physical properties and interfacial adaptation of three epoxy resin-based sealers”. Journal of Endodontics10 (2011): 1417-1421.
  40. Crowther JR. “The ELISA guidebook”. Springer Science and Business Media (2000): 11-22.
  41. Raza I., et al. “Effect of occlusal reduction on frequency of postoperative pain relief, following an endodontic instrumentation”. Pakistan Oral and Dental Journal 4 (2016): 650- 653.
  42. Zeidan BM. “Evaluation the Effect of Occlusal Reduction on Postoperative Pain in Teeth with Irreversible Pulpitis and Mild Tenderness to Percussion”. Journal of Al-Rafidain University College For Sciences 38 (2016): 128-
  43. Asghar S., et al. “Occlusal reduction reduces postoperative pain after endodontic instrumentation”. Pakistan Oral and Dental Journal 3 (2014): 539-542.
  44. Zaman H and Ahmed SS. “Effect of occlusal reduction on post instrumentation pain in patients with acute irreversible pulpitis”. Pakistan Oral and Dental Journal 1 (2016): 119-121.
  45. da Silva EJ., et al. “Postoperative pain after foraminal instrumentation with a reciprocating system and different irrigating solutions”. Brazilian Dental Journal 3 (2015): 216-221.
  46. Kornman KS., et al. “The interleukin-1 genotype as a severity factor in adult periodontal disease”. Journal of Clinical Periodontology 1 (1997): 72-77.
  47. Gemmell E and Seymour GJ. “Interleukin 1, interleukin 6 and transforming growth factors- B production by human gingival mononuclear cells following stimulation with Porphyromonas gingivalis and Fusobacterium nucleatum”. Journal of Periodontal Research 2 (1993): 122-129.
  48. Laxmi I., et al. “Comparison of Inflammatory Markers in Saliva before and after Endodontic Treatment”. Annals of Medical and Health Science Research 11 (2021): 106-112.

Citation

Citation: Nasrin Salem Bazina., et al. “Smile Designing by Gingivectomy Using Chu’s Esthetic Gauge”. Acta Scientific Dental Sciences 6.10 (2022): 100-111.

Copyright

Copyright: © 2022 Nasrin Salem Bazina., 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.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.278

Indexed In





News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 15, 2022.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US