Comparative Evaluation of Premedication with Ketorolac and Prednisolone on Postendodontic Pain

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SCIENCE
Comparative Evaluation of Premedication with Ketorolac and Prednisolone on Postendodontic Pain
Key Take-Away: 

In this clinical trial, comparative assessment of clinical efficacy of prednisolone and Ketorolac has been done, and it has been determined that prednisolone proved to be a better treatment option than ketorolac in Post Endodontic Pain (PEP).

Post-endodontic pain mostly arises during the first 2 days after treatment and generally decreases after a few hours. 

ABSTRACT: 
Background: 

Post-endodontic pain mostly arises during the first 2 days after treatment and generally decreases after a few hours. Many factors influence PEP with the most crucial being concerned to the instrumentation process.

This can trigger an acute periapical inflammatory response secondary to mechanical, chemical and/or microbial injury to the periradicular tissues. Post endodontic pain (PEP) is persistent after endodontic treatment, so, its prevention and management is an integral part of endodontic therapy. The present clinical trial aimed to evaluate and compare the effect of a single pretreatment dose of ketorolac (20 mg), prednisolone (30 mg), and placebo on PEP in patients undergoing endodontic therapy for irreversible pulpitis or pulpal necrosis using a visual analog scale.

Methods: 

Ninety-two patients were included in the present trial; 46 of them had a pulpal diagnosis of irreversible pulpitis, and the other 46 had pulpal necrosis. These patients were randomly allocated into one of the three pre-treatment medication groups: 1) ketorolac (20 mg), 2) prednisolone (30 mg), or 3) a placebo.

The drugs were administered 30 minutes before the procedure, followed by a routine single-visit root canal treatment. The preoperative and postoperative pain was evaluated using a visual analog scale (VAS) at 6-time intervals. A comparison between the different groups was performed using one-way analysis of variance followed by the Tukey post hoc test. A comparison of pain within each group at various time intervals was performed using repeated measures analysis of variance followed by the paired t-test and Bonferroni correction.

Results: 

At the end of 6 hours, in irreversible pulpitis cases, the ketorolac group showed an effective reduction in pain scores compared with the other drugs.

At the end of 12 hours, the prednisolone group significantly reduced the pain scores compared with the other drugs.

Conclusion: 

A single pretreatment dose of prednisolone has a more sustained effect in reducing PEP when compared with placebo or ketorolac.

Source:

Journal of Endodontics

Link to the source:

http://www.sciencedirect.com/science/article/pii/S0099239916310585

The original title of the article:

Comparative Evaluation of Premedication with Ketorolac and Prednisolone on Postendodontic Pain: A Double-blind Randomized Controlled Trial

Authors:

R. Praveen et al.

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