Systematic Review and Meta-analysis on the effect of Preoperative Corticosteroids in Patients with Symptomatic Pulpitis on Postoperative Pain after Single-visit Root Canal Treatment

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Systematic Review and Meta-analysis on the effect of Preoperative Corticosteroids in Patients with Symptomatic Pulpitis on Postoperative Pain after Single-visit Root Canal Treatment
Key Take-Away: 

Corticosteroids are prescribed for a variety of painful conditions like arthritis, RA, lupus etc. This meta-analysis conclusively revealed that preoperative prednisolone was able to reduce the incidence of postoperative pain in single-visit nonsurgical endodontic treatment.

Introduction:

This study explained the following population, comparator, intervention, outcome, timing, study design and setting question in patients suffering from preoperative pain who undergo single-visit nonsurgical endodontic treatment, what is the comparative efficacy of corticosteroids as compared to other analgesics or placebo in lowering postoperative pain and the occurrence of adverse events.

 

Methods:

PubMed/MEDLINE, Scopus, and Cochrane databases were searched to identify published articles using included keywords in different combinations. Research articles were searched manually. The Clinicaltrials.gov site was also explored. Two independent reviewers examined eligibility for inclusion, extracted data, and assessed quality using the risk of bias tool. A meta-analysis, wherever applicable was conducted on the pooled effect size.

 

Results:

The database search recognised 481citations and 37 citations through the manual search. Total of 28 full-text articles was considered after removing duplicates and going through abstracts five articles met the inclusion criteria. The qualitative analysis depicted 4 studies had an unclear risk of bias, and 1 study had a low risk of bias. Only 1 study had a sizable sample size, and others had lesser sample sizes. As per the Meta-analysis, prednisolone administered preoperatively reduced the incidence of postoperative pain at 6, 12, and 24 hours. The treatment in the studies showed no adverse effects.

 

Conclusions:

Corticosteroids may be more effective than placebo for postoperative endodontic pain relief in patients with symptomatic pulpitis undergoing single-visit root canal treatment. Nevertheless, more studies need to be conducted with higher sample sizes to validate the conclusions.

Source

Journal of Endodontics

Link:

https://www.jendodon.com/article/S0099-2399(18)30375-3/fulltext

Original title of article:

Effect of Preoperative Corticosteroids in Patients with Symptomatic Pulpitis on Postoperative Pain after Single-visit Root Canal Treatment: A Systematic Review and Meta-analysis

Authors:

Chinni Suneelkumar et al.

Therapeutic, Corticosteroids, Prednisolone, Postoperative Pain, Symptomatic Pulpitis, Root canal treatment, Systematic Review, Meta-analysis, Steroid hormones, Efficacy
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