Clinical trial proves the efficacy of Dexamethasone Intraligamentary Injection on Post-Endodontic Pain in Patients with Symptomatic Irreversible Pulpitis

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Clinical trial proves the efficacy of Dexamethasone Intraligamentary Injection on Post-Endodontic Pain in Patients with Symptomatic Irreversible Pulpitis

Recent research published in Iranian Endodontic Journal has stated that intraligamentary (PDL) injection of dexamethasone before starting the treatment could significantly reduce the post-treatment endodontic pain in patients having symptomatic irreversible pulpitis.

Mostly endodontic patients consider post-endodontic treatment pain of a tooth to be unavoidable. Management of postoperative endodontic pain is an integral part of endodontic treatment, as it can make a positive influence on reducing fear and anxiety of endodontic patients. Control of post-endodontic pain could be through various techniques and pharmacologic agents.

A clinical trial was done to analyze the effect of the periodontal ligament (PDL) or intraligamentary injection of dexamethasone on start and severity of post-treatment pain in patients with symptomatic irreversible pulpitis.

This was a Randomized Controlled Trial involving 60 volunteers. They were assigned to three groups (n=20). The inclusion criteria for their selection included age group of 18-65 years, systemically healthy patient (ASA I or II) and needed an endodontic treatment on maxillary/mandibular first or second vital molars, symptomatic irreversible pulpitis, PDL without any widening and radiographical presence of periapical lucency.

After administration of local anesthesia and before treatment, group 1 (control) was given PDL injection with a syringe having an empty cartridge, where injection needle just touched the tissues without any penetration. Before the onset of treatment, Group 2 patients were injected with 0.2 mL of 2 % lidocaine containing 1:80000 epinephrine into PDL. In Group 3, the PDL was injected with dexamethasone (8 mg/2 mL). After completion of endodontic treated patients were asked to mark their pain levels on a visual analogue scale (VAS) during the period of next 48 h (on 6, 12, 24 and 48-h intervals). They were also asked to reveal if they had any analgesics along with its dosage.

VAS ruler comprised 0-170 markings for the level of pain. It scored pain level with Score 0 (mild pain; 0-56), score 1 (moderate pain; 57-113) and score 3 (severe pain; 114-170). Kruskal-Wallis and the Chi-square tests were used to analyze the data, and the level of significance was set at 0.05.

It was evaluated that, after 6 and 12 h, group 1 showed highest pain value (p<0.01) and group 3 represented lowest pain values (p<0.001). No important difference was noted in pain after 24 and 48 h between groups 1 and 2 (p<0.6). Group 3 was estimated with lower pain levels (p<0.01 and p<0.8 for 24 and 48 h, respectively).

Source:

Iran Endod J. 2016 Fall; 11(4): 261–266.

Link to the source:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5069900/

The original title of the article:

Effect of Dexamethasone Intraligamentary Injection on Post-Endodontic Pain in Patients with Symptomatic Irreversible Pulpitis: A Randomized Controlled Clinical Trial

Authors:

D'Angelo S, Tramontano G et al.

 

SearchTags: 
Dexamethasone, Post-Endodontic Pain, Symptomatic Irreversible Pulpitis
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