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