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Al Attas MH, Maria RD. Assessing the Efficacy of Cold Laser Therapy vs. Traditional Methods in Managing Post-Endodontic Pain: A Randomized Controlled Trial. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S516-S519. [PMID: 38595560 PMCID: PMC11001120 DOI: 10.4103/jpbs.jpbs_839_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 09/15/2023] [Accepted: 09/22/2023] [Indexed: 04/11/2024] Open
Abstract
The background of the study highlighted the common occurrence of post-endodontic pain and the need for effective pain management strategies. Materials and Methods Fifty patients were randomly assigned to two groups: the cold laser therapy (CLT) group and the traditional methods group (TMG). The CLT group received laser treatment at the affected area immediately following endodontic treatment, whereas the TMG received standard pain management techniques such as analgesics. Pain levels were assessed using a visual analog scale at baseline and at 6, 12, 24, and 48 hours post treatment. Pain scores were analyzed using appropriate statistical methods, including analysis of variance, and P values were calculated to determine the significance of differences between groups. Results This study found significant differences in post-endodontic pain levels between CLT and standard procedures. At 6 hours post treatment, the CLT group had a mean pain score of 2.1 ± 0.8, whereas the TMG had a mean pain score of 3.8 ± 1.2 (P = 0.012). Pain levels in the CLT group decreased with time, with scores decreasing to 1.5 ± 0.6 at 12 hours, 1.2 ± 0.5 at 24 hours, and 0.9 ± 0.4 at 48 hours post treatment. In contrast, the TMG had greater pain scores at each time point: 3.2 ± 1.0, 2.9 ± 1.1, 2.5 ± 0.9, and 2.1 ± 0.8 at 12, 24, and 48 hours post treatment, respectively. At 12, 24, and 48 hours post treatment, P values of 0.021, 0.036, and 0.004, respectively, indicated significant differences. Conclusion In managing post-endodontic pain, CLT demonstrated superior efficacy compared to traditional methods.
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Affiliation(s)
- Mustafa Hussein Al Attas
- Department of Conservative Dentistry and Endodontics, College of Dentistry, Qassim University, Buraydah, Saudi Arabia
| | - Rahul D. Maria
- Department of Conservative Dentistry and Endodontics, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
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Pessano S, Gloeck NR, Tancredi L, Ringsten M, Hohlfeld A, Ebrahim S, Albertella M, Kredo T, Bruschettini M. Ibuprofen for acute postoperative pain in children. Cochrane Database Syst Rev 2024; 1:CD015432. [PMID: 38180091 PMCID: PMC10767793 DOI: 10.1002/14651858.cd015432.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
BACKGROUND Children often require pain management following surgery to avoid suffering. Effective pain management has consequences for healing time and quality of life. Ibuprofen, a frequently used non-steroidal anti-inflammatory drug (NSAID) administered to children, is used to treat pain and inflammation in the postoperative period. OBJECTIVES 1) To assess the efficacy and safety of ibuprofen (any dose) for acute postoperative pain management in children compared with placebo or other active comparators. 2) To compare ibuprofen administered at different doses, routes (e.g. oral, intravenous, etc.), or strategies (e.g. as needed versus as scheduled). SEARCH METHODS We used standard Cochrane search methods. We searched CENTRAL, MEDLINE, Embase, CINAHL and trials registries in August 2023. SELECTION CRITERIA We included randomised controlled trials (RCTs) in children aged 17 years and younger, treated for acute postoperative or postprocedural pain, that compared ibuprofen to placebo or any active comparator. We included RCTs that compared different administration routes, doses of ibuprofen and schedules. DATA COLLECTION AND ANALYSIS We adhered to standard Cochrane methods for data collection and analysis. Our primary outcomes were pain relief reported by the child, pain intensity reported by the child, adverse events, and serious adverse events. We present results using risk ratios (RR) and standardised mean differences (SMD), with the associated confidence intervals (CI). We used GRADE to assess the certainty of the evidence. MAIN RESULTS We included 43 RCTs that enroled 4265 children (3935 children included in this review). We rated the overall risk of bias at the study level as high or unclear for 37 studies that had one or several unclear or high risk of bias judgements across the domains. We judged six studies as having a low risk of bias across all domains. Ibuprofen versus placebo (35 RCTs) No studies reported pain relief reported by the child or a third party, or serious adverse events. Ibuprofen probably reduces child-reported pain intensity less than two hours postintervention compared to placebo (SMD -1.12, 95% CI -1.39 to -0.86; 3 studies, 259 children; moderate-certainty evidence). Ibuprofen may reduce child-reported pain intensity, two hours to less than 24 hours postintervention (SMD -1.01, 95% CI -1.24 to -0.78; 5 studies, 345 children; low-certainty evidence). Ibuprofen may result in little to no difference in adverse events compared to placebo (RR 0.79, 95% CI 0.51 to 1.23; 5 studies, 384 children; low-certainty evidence). Ibuprofen versus paracetamol (21 RCTs) No studies reported pain relief reported by the child or a third party, or serious adverse events. Ibuprofen likely reduces child-reported pain intensity less than two hours postintervention compared to paracetamol (SMD -0.42, 95% CI -0.82 to -0.02; 2 studies, 100 children; moderate-certainty evidence). Ibuprofen may slightly reduce child-reported pain intensity two hours to 24 hours postintervention (SMD -0.21, 95% CI -0.40 to -0.02; 6 studies, 422 children; low-certainty evidence). Ibuprofen may result in little to no difference in adverse events (0 events in each group; 1 study, 44 children; low-certainty evidence). Ibuprofen versus morphine (1 RCT) No studies reported pain relief or pain intensity reported by the child or a third party, or serious adverse events. Ibuprofen likely results in a reduction in adverse events compared to morphine (RR 0.58, 95% CI 0.40 to 0.83; risk difference (RD) -0.25, 95% CI -0.40 to -0.09; number needed to treat for an additional beneficial outcome (NNTB) 4; 1 study, 154 children; moderate-certainty evidence). Ibuprofen versus ketorolac (1 RCT) No studies reported pain relief or pain intensity reported by the child, or serious adverse events. Ibuprofen may result in a reduction in adverse events compared to ketorolac (RR 0.51, 95% CI 0.27 to 0.96; RD -0.29, 95% CI -0.53 to -0.04; NNTB 4; 1 study, 59 children; low-certainty evidence). AUTHORS' CONCLUSIONS Despite identifying 43 RCTs, we remain uncertain about the effect of ibuprofen compared to placebo or active comparators for some critical outcomes and in the comparisons between different doses, schedules and routes for ibuprofen administration. This is largely due to poor reporting on important outcomes such as serious adverse events, and poor study conduct or reporting that reduced our confidence in the results, along with small underpowered studies. Compared to placebo, ibuprofen likely results in pain reduction less than two hours postintervention, however, the efficacy might be lower at two hours to 24 hours. Compared to paracetamol, ibuprofen likely results in pain reduction up to 24 hours postintervention. We could not explore if there was a different effect in different kinds of surgeries or procedures. Ibuprofen likely results in a reduction in adverse events compared to morphine, and in little to no difference in bleeding when compared to paracetamol. We remain mostly uncertain about the safety of ibuprofen compared to other drugs.
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Affiliation(s)
- Sara Pessano
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto G. Gaslini, Genoa, Italy
| | - Natasha R Gloeck
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Luca Tancredi
- Geriatrie, Hessing Stiftung, Augsburg, Germany
- Medical School, Regiomed, Coburg, Germany
| | - Martin Ringsten
- Cochrane Sweden, Department of Research and Education, Skåne University Hospital, Lund University, Lund, Sweden
| | - Ameer Hohlfeld
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Sumayyah Ebrahim
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Surgery, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | | | - Tamara Kredo
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Clinical Pharmacology, Department of Medicine and Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Matteo Bruschettini
- Cochrane Sweden, Department of Research and Education, Skåne University Hospital, Lund University, Lund, Sweden
- Paediatrics, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
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Synthesis, characterization, and application of external gelation of sodium alginate nanoparticles in molecular imprinting for separation and drug delivery of tenoxicam. CHEMICAL PAPERS 2022. [DOI: 10.1007/s11696-022-02639-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Kumar G, Sangwan P, Tewari S. Effect of premedication on postoperative pain after root canal therapy in patients with irreversible pulpitis: a systematic review and meta-analysis. J Dent Anesth Pain Med 2021; 21:397-411. [PMID: 34703890 PMCID: PMC8520836 DOI: 10.17245/jdapm.2021.21.5.397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/21/2021] [Accepted: 07/28/2021] [Indexed: 01/14/2023] Open
Abstract
This systematic review aimed to assess the effect of premedication on postoperative pain after root canal treatment in vital teeth. Five electronic databases were searched for randomized clinical trials, and two independent reviewers selected eligible studies, extracted data, and assessed the quality of studies using the Cochrane Risk of Bias tool. Meta-analysis was conducted using the random-effects model, and the pooled effect estimate of the standardized mean difference (SMD) between premedication and placebo was calculated. Subgroup analysis was conducted based on the class and route of the drug. Studies with a high risk of bias were excluded from the sensitivity analysis. Ten trials satisfied the inclusion criteria, of which eight were included in the meta-analysis. Premedication was more effective in reducing postoperative pain than placebo at 6 hours (SMD = −1.00; 95% confidence interval [CI] = −1.33 to −0.66), 12 hours (SMD = −0.80; 95% CI = −1.05 to −0.56), and 24 hours (SMD = −0.72; 95% CI = −1.02 to −0.43). The results of the sensitivity analysis confirmed the findings of the primary analysis. Based on these results, it can be concluded that premedication is effective in reducing postoperative pain in teeth with irreversible pulpitis. However, additional quality studies are required for further validation.
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Affiliation(s)
- Gaurav Kumar
- Post Graduate Institute of Dental Sciences Rohtak, Haryana, India
| | - Pankaj Sangwan
- Post Graduate Institute of Dental Sciences Rohtak, Haryana, India
| | - Sanjay Tewari
- Post Graduate Institute of Dental Sciences Rohtak, Haryana, India
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VENKATA TEJA K, RAMESH S, RAMESH S. Analgesic Effect of Pre-emptive oral NSAIDs on Post-endodontic Pain levels in Single Visit Endodontics -A Systematic Review. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.871091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Medications Used for Prevention and Treatment of Postoperative Endodontic Pain: A Systematic Review. Eur Endod J 2021; 6:15-24. [PMID: 33609020 PMCID: PMC8056801 DOI: 10.14744/eej.2020.85856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: Prevention and management of postoperative endodontic pain is a common challenge for the endodontists. This systematic review was conducted to evaluate the efficacy and safety of medicament therapeutic protocols in the prevention and management of endodontic pain. Methods: A literature search was undertaken in MEDLINE, Cochrane Library, LILACs, and SciELO, for articles published until December 2017, without year restriction and written only in English. An additional search was performed in the references of the retrieved studies. Study eligibility criteria, participants, and interventions: The inclusion criteria were randomised clinical trials that evaluated the use of medications to prevent or control moderate to severe pain in adult patients, using a visual analog scale as a tool for pain measurement. The primary outcome evaluated was the reduction of pain scores. The second outcome evaluated was the need for additional analgesia and the occurrence of adverse events. Study appraisal and synthesis methods: The quality assessment of the included studies was performed following the Jadad scale to measure the likelihood of bias in pain research reports. Results: After removing duplicates and excluding the studies that did not meet the selection criteria, ten studies were included tin the systematic review. Among these studies, five studies administered the medications before the endodontic procedures and five studies after. These studies evaluated non-opioid analgesics (acetaminophen), opioid analgesics (tramadol and codeine), nonsteroidal anti-inflammatories (ibuprofen, flurbiprofen, ketorolac tromethamine, etodolac, tenoxicam, and naproxen), steroidal anti-inflammatory (prednisolone) or the association of medications to prevent or control postoperative pain. It was possible to establish a significant relationship between the use of additional analgesics and periapical diagnosis. Adverse events were not observed when the administration occurred before the endodontic procedure. When it was administered after the procedure, adverse reactions were reported in 2 of 3 trials included in the analysis. Limitations: A restricted number of randomised clinical trials were found, and the difference in the methodology of the studies did not meet the definition of a systemic treatment protocol for prevention or control of postoperative pain. Conclusion: Nonsteroidal anti-inflammatory drugs are the most common medicament to prevent and control postoperative pain, with ibuprofen being the most investigated. There is a significant association between the use of additional analgesics and periapical diagnoses.
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Almuthhin M, Afify M, Alshammari Y, Alkatheeri N, Altuwaijri SM, Alhussain B, Albaij SMA, Alanazi F, Alsheri Y. The Safety and Efficacy of Pre- and Post-Medication for Postoperative Endo- dontic Pain: A Systematic Review and Network Meta-analysis. Open Dent J 2020. [DOI: 10.2174/1874210602014010563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Postoperative Endodontic Pain is a major concern for dentists and their patients, with pain having been reported to occur in 25%–40% of patients treated. Therefore, the aim of this systematic review and Network Meta-analysis (NMA) was to identify the safety and efficacy of pre- and post-medication for reducing postoperative endodontic pain.
Methods:
A literature search was performed in the SCOPUS, MEDLINE, and ScienceDirect, and Cochrane Central databases until December 2019 with no language restriction. Randomized controlled trials evaluating the efficacy of pre- or post-medications compared with other agents, placebo, or no treatment in adult patients who underwent endodontic surgery for postoperative pain were included. The mean difference of postoperative pain was measured using the Standardized Mean Difference (SMD) with its 95% confidence interval (95% CI).
Results:
This Systematic Review included 62 Articles. Of them, 50 studies were included in the NMA. Among all medications, corticosteroids were ranked as the best treatment for the reduction of postoperative pain at 6 and 12 hours with a significant reduction in postoperative pain scores [SMD= -1.18, 95% CI (-1.51: -0.85)] and [SMD= -1.39, 95% CI (-1.77: -1.02)], respectively. Cyclooxygenase-2 (COX-2) inhibitors were ranked as the best treatment for the reduction of postoperative pain at 8 and 24 hours with a significant reduction in postoperative pain scores [SMD= -2.86, 95% CI (-6.05: -1.66)] and [SMD= -1.27, 95% CI (-2.10: -0.43)], respectively. Non-steroidal anti-inflammatory drugs (NSAIDs) significantly reduced the postoperative pain scores in all durations. For postoperative pain at 6 hours, Indomethacin, Novafen, Naproxen, Prednisolone, Ketorolac, Betamethasone, Dexamethasone, Deflazacort, Rofecoxib, Piroxicam, and Ibuprofen significantly reduced the pain score when compared with a placebo. All of these drugs demonstrated a significant reduction at 12 hours except Ketorolac.
Conclusion:
The current evidence suggests that pre- and post-medication can reduce postoperative pain after nonsurgical root canal treatment. Corticosteroids and COX-2 inhibitors showed significant control of the pain up to 12 hours after administration. However, NSAIDs demonstrated a high efficacy from administration and until two days after treatment. Indomethacin, Novafen, prednisolone, and Naproxen were ranked first in most analyzed durations.
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Suresh N, Nagendrababu V, Koteeswaran V, Haritha JS, Swetha SD, Varghese A, Natanasabapathy V. Effect of preoperative oral administration of steroids in comparison to an anti-inflammatory drug on postoperative pain following single-visit root canal treatment - a double-blind, randomized clinical trial. Int Endod J 2020; 54:198-209. [PMID: 32976660 DOI: 10.1111/iej.13416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/04/2020] [Accepted: 09/17/2020] [Indexed: 01/01/2023]
Abstract
AIM This randomized, double-blinded, clinical trial evaluated the effect of oral premedication of piroxicam, prednisolone, dexamethasone or placebo on postoperative pain after single-visit root canal treatment in teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis. METHODOLOGY The trial is reported according to the Preferred Reporting Items for RAndomized Trials in Endodontics (PRIRATE) 2020 guidelines. The protocol was registered at the clinical trial registry (India) (CTRI/2019/06/019818). In total, 160 patients, assigned to four groups, received orally either 20 mg piroxicam, 20 mg prednisolone, 4 mg dexamethasone or a placebo 60 min before root canal treatment. Patients recorded their postoperative pain intensity at 6, 12, 24, 48 and 72 h using a 10-cm visual analogue scale. Intergroup comparison was performed using Kruskal-Wallis tests with post hoc analysis using Dunns test. Incidence of pain was analysed using chi-square tests. A P value < 0.05 was considered to be statistically significant. Binary logistic regression was used to determine the odds of postoperative pain, with incidence of pain as the dependent variable and intervention groups, gender, age and type of tooth as independent variables. RESULTS In total, 156 patients were analysed in the trial, since four patients dropped out during follow-up. All drugs were associated with a significantly lower incidence of postoperative pain compared to the placebo at 6 h (P = 0.009), 12 h (P = 0.003) and 24 h (P = 0.008). Mean intensity of pain was significantly more intense at 6, 12 and 24 h with the use of placebo in comparison to the other three intervention groups (P < 0.05). Intensity of pain was not significantly different between the premedications used (P > 0.05). One patient in the piroxicam group reported gastritis, whereas no adverse effects were recorded in other groups. CONCLUSION Preoperative oral administration of a single dose of 4 mg dexamethasone, 20 mg piroxicam or 20 mg prednisolone reduced the incidence and severity of postoperative pain following single-visit root canal treatment compared to a placebo in patients with symptomatic irreversible pulpitis and symptomatic apical periodontitis up to 24 h. The odds of postoperative pain at 24 h for patients premedicated with 4 mg dexamethasone or 20 mg piroxicam or 20 mg prednisolone were 5.3 times, 3.4 times and 2.5 times less compared to the placebo, respectively.
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Affiliation(s)
- N Suresh
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - V Nagendrababu
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.,Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - V Koteeswaran
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - J S Haritha
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - S D Swetha
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - A Varghese
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - V Natanasabapathy
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
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Stamos A, Drum M, Reader A, Nusstein J, Fowler S, Beck M. An Evaluation of Ibuprofen Versus Ibuprofen/Acetaminophen for Postoperative Endodontic Pain in Patients With Symptomatic Irreversible Pulpitis and Symptomatic Apical Periodontitis. Anesth Prog 2020; 66:192-201. [PMID: 31891295 DOI: 10.2344/anpr-66-03-06] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The purpose of this investigation was to compare ibuprofen versus an ibuprofen/acetaminophen combination for postoperative pain control in a patient model specific to teeth diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis. One hundred and two patients presenting with moderate to severe pain from a maxillary or mandibular posterior tooth diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis were included. Following local anesthetic administration, complete endodontic cleaning and shaping was performed. Patients were randomly assigned to receive identically appearing tablets of ibuprofen 200 mg or a combination of ibuprofen 200 mg/acetaminophen 216.7 mg with instructions to take 3 tablets every 6 hours as needed for pain. Patients were also given a prescription for an escape medication to take if the study medications did not adequately control their pain. A 4-day diary was used to record pain ratings and medication use. Moderate to severe pain was experienced by 59-61% of the patients on postoperative day 1 and 50-57% of the patients on day 2, with the pain ratings decreasing over the next 2 days. There were no statistically significant differences between the 2 groups in postoperative pain, percussion pain, or medication use. There was no difference between ibuprofen and the combination of ibuprofen/acetaminophen in the reduction of postoperative pain following endodontic debridement in patients with symptomatic irreversible pulpitis and symptomatic apical periodontitis.
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Affiliation(s)
- Alex Stamos
- Former Graduate Student in Endodontics, The Ohio State University
| | - Melissa Drum
- Professor and Graduate Program Director, Division of Endodontics, The Ohio State University
| | - Al Reader
- Emeritus Professor, Division of Endodontics, The Ohio State University
| | - John Nusstein
- Professor and Chair, Division of Endodontics, The Ohio State University
| | - Sara Fowler
- Assistant Professor and Predoctoral Director, Division of Endodontics, The Ohio State University
| | - Mike Beck
- Emeritus Associate Professor, Division of Biosciences, The Ohio State University
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Nagendrababu V, Pulikkotil SJ, Jinatongthai P, Veettil SK, Teerawattanapong N, Gutmann JL. Efficacy and Safety of Oral Premedication on Pain after Nonsurgical Root Canal Treatment: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. J Endod 2019; 45:364-371. [DOI: 10.1016/j.joen.2018.10.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/23/2018] [Accepted: 10/30/2018] [Indexed: 10/27/2022]
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Konagala RK, Mandava J, Pabbati RK, Anupreeta A, Borugadda R, Ravi R. Effect of pretreatment medication on postendodontic pain: A double-blind, placebo-controlled study. J Conserv Dent 2019; 22:54-58. [PMID: 30820083 PMCID: PMC6385568 DOI: 10.4103/jcd.jcd_135_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/15/2018] [Accepted: 01/25/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Posttreatment endodontic pain has been reported in 25%-40% of all endodontic patients. Effective management of endodontic pain represents a continuing challenge. AIM To evaluate and compare the efficacy of preoperative single dose of nonsteroidal anti-inflammatory drug, piroxicam (20 mg), with two types of corticosteroid drugs - dexamethasone (4 mg) or deflazacort (30 mg) - for the prevention and control of postendodontic pain. MATERIALS AND METHODS A total of 132 volunteers selected for nonsurgical root canal therapy were randomly divided into the following four groups (n = 30 each) according to preoperative medication given: Group 1, piroxicam (20 mg); Group 2, dexamethasone (4 mg); Group 3, deflazacort (30 mg); and Group 4, placebo. The preoperative medications were administrated 1 h before the start of standard endodontic treatment. Patients were instructed to complete a pain diary using Visual Analog Scale preoperatively and at 6-, 12-, 24-, 48-, and 72-h intervals after root canal instrumentation. STATISTICAL ANALYSIS The correlation between preoperative endodontic pain to postoperative pain and pair-wise comparison of four groups was evaluated by Kruskal-Wallis analysis of variance test followed by Mann-Whitney U-test. RESULTS Compared to the placebo group, piroxicam, dexamethasone, and deflazacort resulted in a statistically significant reduction in postendodontic pain at 6, 12, and 24 h (P < 0.05). CONCLUSION Preoperative single oral dose of piroxicam or dexamethasone or deflazacort is equally effective in controlling postendodontic pain.
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Affiliation(s)
- Ravi Kumar Konagala
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Jyothi Mandava
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Ravi Kumar Pabbati
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - A. Anupreeta
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Roopesh Borugadda
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Ravichandra Ravi
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
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Effects of Ibuprofen Compared to Other Premedication Drugs on the Risk and Intensity of Postendodontic Pain: A Systematic Review. Eur Endod J 2018; 3:123-133. [PMID: 32161868 PMCID: PMC7006579 DOI: 10.14744/eej.2018.83803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/12/2018] [Accepted: 08/10/2018] [Indexed: 11/20/2022] Open
Abstract
Objective This systematic review aims to evaluate the effects of ibuprofen compared to other drugs on the risk and intensity of postoperative pain resulting from endodontic treatment in adult patients. Methods A systematic search was carried out through Medline databases (Pubmed, Scopus, Web of Science, Cochrane, Lilacs, and BBO). There was no restriction on the publication year or idiom. The gray literature was explored. The Periodicos Capes Theses Databases and ProQuest Dissertations were also searched, as well as the unpublished and ongoing trials registry and the IADR abstracts (1990-2016). Solely randomized clinical trials that compared the risk or intensity of pain resulting from endodontic treatment in adult patients were included in this systematic review. The risk of bias of the articles was evaluated using the Cochrane Collaboration's tool. A random-effect meta-analysis was conducted for ibuprofen versus placebo and ibuprofen versus other drugs at 6, 8, and 24 hours. The GRADE approach was used to assess the quality of the evidence. Results A total of 1132 studies were identified, and only seven meet the eligibility criteria. No difference between the groups was detected in any of the meta-analysis. An exception was observed when one study was removed from the meta-analysis of pain intensity at 24 hours for ibuprofen versus placebo, favoring ibuprofen (SMD -0.67; 95% CI -1.05 to -0.17). The quality of evidence in all meta-analyses was graded as low or very low. Conclusion Results of the present systematic review indicate that there is no clear evidence supporting that preoperative ibuprofen is better than other drugs in reducing the risk and intensity of postendodontic pain.
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Shafie L, Esmaili S, Parirokh M, Pardakhti A, Nakhaee N, Abbott PV, Barghi H. Efficacy of Pre-Medication with Ibuprofen on Post-Operative Pain after Pulpotomy in Primary Molars. IRANIAN ENDODONTIC JOURNAL 2018; 13:216-220. [PMID: 29707018 PMCID: PMC5911297 DOI: 10.22037/iej.v13i2.16624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/04/2018] [Accepted: 01/17/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Pain management following dental procedures, particularly pulpotomies and extraction, is of great importance in pediatric dentistry. The aim of this study was to investigate the efficacy of pre-treatment with ibuprofen on post-operative pain following pulpotomy of primary molars. METHODS AND MATERIALS In a split mouth double-blinded randomized clinical trial, 49 children aging between 6-10 years old were given either ibuprofen or a placebo 45 min prior to the treatment. After pulpotomy and placement of a stainless steel crown (SSC), the pain level was evaluated using the Wong-Baker face visual analogue scale for up to 7 days post-treatment. McNemar and Wilcoxon tests were used for data analysis. RESULTS Forty-five patients were eligible to participate in this study. Pre-medication with ibuprofen significantly reduced pain during the first 24 h post-treatment (P=0.032). However, there was no significant difference in the pain levels between placebo and ibuprofen groups at 48 and 72 h post-treatment (P=0.154 and P=0.197, respectively). The number of times patients needed analgesics in ibuprofen group was significantly lower compared to that in the placebo group (P=0.008). CONCLUSION Pre-medication with ibuprofen resulted in less pain following pulpotomy and SSC placement in primary teeth.
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Affiliation(s)
- Lili Shafie
- Pedodontist, Fellowship in Sedation and Hospital Dentistry, Kerman, Iran;
| | - Sara Esmaili
- Department of Pediatric Dentistry, Dental School, Hormozgan University of Medical Sciences, Bandar Abbas, Iran;
| | - Masoud Parirokh
- Endodontology Research Center, Dental School, Kerman University of Medical Sciences, Kerman, Iran;
| | - Abbas Pardakhti
- Pharmaceutics Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran;
| | - Nouzar Nakhaee
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran;
| | - Paul V. Abbott
- Dental School, University of Western Australia, Perth, Australia;
| | - Hamide Barghi
- Department of Pediatric Dentistry, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran
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Santini MF, Rosa RAD, Ferreira MBC, Fischer MI, Souza EM, Só MVR. Comparison of two combinations of opioid and non-opioid analgesics for acute periradicular abscess: a randomized clinical trial. J Appl Oral Sci 2017; 25:551-558. [PMID: 29069153 PMCID: PMC5804392 DOI: 10.1590/1678-7757-2016-0407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 02/27/2017] [Indexed: 11/27/2022] Open
Abstract
Acute periradicular abscess is a condition characterized by the formation and propagation of pus in the periapical tissues and generally associated with debilitating pain.
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Affiliation(s)
- Manuela Favarin Santini
- Universidade Federal do Rio Grande do Sul, Departamento de Odontologia Conservadora, Porto Alegre, RS, Brasil
| | - Ricardo Abreu da Rosa
- Universidade Federal do Rio Grande do Sul, Departamento de Odontologia Conservadora, Porto Alegre, RS, Brasil
| | - Maria Beatriz Cardoso Ferreira
- Universidade Federal do Rio Grande do Sul, Instituto de Ciências Básicas da Saúde, Departamento de Farmacologia, Porto Alegre, RS, Brasil
| | - Maria Isabel Fischer
- Universidade Federal do Rio Grande do Sul, Departamento de Produção e Controle de Medicamentos, Porto Alegre, RS, Brasil
| | - Erick Miranda Souza
- Universidade Federal do Maranhão, Departamento de Odontologia II, São Luís, MA, Brasil
| | - Marcus Vinícius Reis Só
- Universidade Federal do Rio Grande do Sul, Departamento de Odontologia Conservadora, Porto Alegre, RS, Brasil
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Elkhadem A, Ezzat K, Ramadan M, AbdelGhaffar S, Khamis D, Hassan A, Abdel-Mawgoud A, Mamdouh A, AbouZeid M, Amin S. The effect of preoperative oral administration of prednisolone on postoperative pain in patients with symptomatic irreversible pulpitis: a single-centre randomized controlled trial. Int Endod J 2017; 51 Suppl 3:e189-e196. [PMID: 28560802 DOI: 10.1111/iej.12795] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 05/25/2017] [Indexed: 11/26/2022]
Abstract
AIM This single-centre randomized, double-blind, placebo-controlled clinical trial assessed the effect of a preoperative, single, oral dose of prednisolone on postoperative pain and postoperative analgesic intake in patients with symptomatic, irreversible pulpitis in mandibular molars. METHODOLOGY Four hundred participants, randomly assigned to two equal groups, received either 40 mg prednisolone or placebo tablets 30 min before single-visit root canal treatment. Patients recorded their pain level 6, 12 and 24 h after treatment on a 100-mm visual analogue scale. All patients received a sham capsule to take if needed as a postoperative analgesic, and, if the pain persisted, an analgesic was prescribed. The relative risk reduction and 95% confidence intervals (CI) were estimated for binary data. Mann-Whitney U-test was used to compare postoperative pain intensity between groups. RESULTS The relative risk reduction in pain incidence was 20.31% (95% CI: 12.03%, 27.82%) at 6 h, 23.39% (95% CI: 14.75%, 31.16%) at 12 h and 28.85% (95% CI: 18.08%, 38.20%) at 24 h. Prednisolone had significantly less post-obturation pain intensity compared to placebo at 6, 12 and 24 h (P < 0.001). The relative risk reduction in sham-capsule intake was 54% (95% CI: 38%, 66%) and of analgesic intake was 55% (95% CI: 3%, 79%). No adverse effects were recorded. CONCLUSION Preoperative oral administration of a single dose of 40 mg prednisolone was beneficial to control short-term post-obturation pain after single-visit root canal treatment in patients with symptomatic irreversible pulpitis reducing pain incidence after 24 h by approximately 30% and postoperative analgesic intake by approximately 55%.
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Affiliation(s)
- A Elkhadem
- Centre for Evidence-Based Dentistry, Cairo University, Cairo, Egypt
| | - K Ezzat
- Department of Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - M Ramadan
- Department of Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - S AbdelGhaffar
- Department of Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - D Khamis
- Department of Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - A Hassan
- Department of Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - A Abdel-Mawgoud
- Department of Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - A Mamdouh
- Department of Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - M AbouZeid
- Department of Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - S Amin
- Department of Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
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Comparative Evaluation of Premedication with Ketorolac and Prednisolone on Postendodontic Pain: A Double-blind Randomized Controlled Trial. J Endod 2017; 43:667-673. [DOI: 10.1016/j.joen.2016.12.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 12/08/2016] [Accepted: 12/11/2016] [Indexed: 11/20/2022]
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Smith EA, Marshall JG, Selph SS, Barker DR, Sedgley CM. Nonsteroidal Anti-inflammatory Drugs for Managing Postoperative Endodontic Pain in Patients Who Present with Preoperative Pain: A Systematic Review and Meta-analysis. J Endod 2016; 43:7-15. [PMID: 27939729 DOI: 10.1016/j.joen.2016.09.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/07/2016] [Accepted: 09/09/2016] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Nonsteroidal anti-inflammatory drugs (NSAIDs) have been commonly used to treat endodontic postoperative pain. The purpose of this study was to address the following Population, Intervention, Comparator, Outcome, Timing, Study design and setting question: in patients with preoperative pain who undergo initial orthograde endodontic treatment, what is the comparative efficacy of NSAIDS compared with non-narcotic analgesics or placebo in reducing postoperative pain and the incidence of adverse events. METHODS Ovid MEDLINE (1946-December 15, 2015), the Cochrane Database of Systematic Reviews (2005-December 15, 2015), and the Cochrane Central Register of Controlled Trials (to December 15, 2015) were searched using included drugs, indications, and study designs as search terms. Hand searches in texts were also conducted. Two independent reviewers assessed eligibility for inclusion, extracted data, and assessed quality using the risk of bias tool. L'Abbe plots were used for qualitative review. Where applicable, meta-analysis was conducted on the pooled effect size (ES). RESULTS Two thousand two hundred eighty-four studies were identified through the database searches; 405 full-text articles were assessed. Fifteen articles met the inclusion criteria; qualitative analysis revealed all studies had a moderate to high risk of bias. Ibuprofen was the most studied NSAID. The L'Abbe plots showed that NSAIDS are effective at relieving postoperative endodontic pain overall. Meta-analysis showed that ibuprofen 600 mg is more effective than placebo at 6 hours postoperatively (ES = 10.50, P = .037), and ibuprofen 600 mg + acetaminophen 1000 mg combination is more effective than placebo (ES = 34.89, P = .000) but not significantly different than ibuprofen (ES = 13.94, P = .317). Five studies reported patients experiencing adverse events such as drowsiness, dizziness, nausea, and emesis; 2 studies reported that patients experienced no adverse events. CONCLUSIONS A combination of ibuprofen 600 mg and acetaminophen 1000 mg is more effective than placebo but not significantly different than ibuprofen 600 mg at 6 hours postoperatively. Ibuprofen 600 mg is more effective than placebo at 6 hours postoperatively; however, there are insufficient data to recommend the most effective NSAID, dose amount, or dose interval for the relief of postoperative endodontic pain of longer duration in patients with preoperative pain.
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Affiliation(s)
- Elizabeth A Smith
- Department of Endodontology, School of Dentistry, Oregon Health and Science University, Portland, Oregon
| | - J Gordon Marshall
- Department of Endodontology, School of Dentistry, Oregon Health and Science University, Portland, Oregon
| | - Shelley S Selph
- Pacific Northwest Evidence-based Practice Center, Oregon Health and Science University, Portland, Oregon
| | - Dale R Barker
- Department of Endodontology, School of Dentistry, Oregon Health and Science University, Portland, Oregon
| | - Christine M Sedgley
- Department of Endodontology, School of Dentistry, Oregon Health and Science University, Portland, Oregon.
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Mehrvarzfar P, Esnashari E, Salmanzadeh R, Fazlyab M, Fazlyab M. Effect of Dexamethasone Intraligamentary Injection on Post-Endodontic Pain in Patients with Symptomatic Irreversible Pulpitis: A Randomized Controlled Clinical Trial. IRANIAN ENDODONTIC JOURNAL 2016; 11:261-266. [PMID: 27790253 PMCID: PMC5069900 DOI: 10.22037/iej.2016.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: The aim of this randomized-controlled clinical trial was to assess the effect of intraligamentary (PDL) injection of dexamethasone on onset and severity of post-treatment pain in patients with symptomatic irreversible pulpitis. Methods and Materials: A total number of 60 volunteers were included according to the inclusion criteria and were assigned to three groups (n=20). After administration of local anesthesia and before treatment, group 1 (control) PDL injection was done with syringe containing empty cartridge, while in groups 2 and 3 the PDL injection was done with 0.2 mL of 2% lidocaine or dexamethasone (8 mg/2 mL), respectively. Immediately after endodontic treatment patients were requested to mark their level of pain on a visual analogue scale (VAS) during the next 48 h (on 6, 12, 24 and 48-h intervals). They were also asked to mention whether analgesics were taken and its dosage. Considering the 0-170 markings on the VAS ruler, the level of pain was scored as follows: score 0 (mild pain; 0-56), score 1 (moderate pain; 57-113) and score 3 (severe pain; 114-170). The data were analyzed using the Kruskal-Wallis and the Chi-square tests and the level of significance was set at 0.05. Results: After 6 and 12 h, group 1 and group 3 had the highest and lowest pain values, respectively (P<0.01 and P<0.001 for 6 and 12 h, respectively). However, after 24 and 48 h the difference in the pain was not significant between groups 1 and 2 (P<0.6) but group 3 had lower pain levels (P<0.01 and P<0.8 for 24 and 48 h, respectively). Conclusion: Pretreatment PDL injection of dexamethasone can significantly reduce the post-treatment endodontic pain in patients with symptomatic irreversible pulpitis.
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Affiliation(s)
- Payman Mehrvarzfar
- Department of Endodontics, Dental Branch, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Ehsan Esnashari
- Department of Endodontics, Dental Branch, Islamic Azad University of Medical Sciences, Tehran, Iran
| | | | - Mahta Fazlyab
- Department of Endodontics, Dental Branch, Islamic Azad University of Medical Sciences, Tehran, Iran;; Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahyar Fazlyab
- Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, USA
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Arslan H, Gündoğdu EC, Sümbüllü M. The Effect of Preoperative Administration of Antihistamine, Analgesic and Placebo on Postoperative Pain in Teeth with Symptomatic Apical Periodontitis: A Randomized Controlled Trial. Eur Endod J 2016; 1:1-5. [PMID: 32566902 PMCID: PMC7299059 DOI: 10.5152/eej.2016.16012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 06/23/2016] [Accepted: 07/27/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: To compare the effect of preoperative administration of an antihistamine, an analgesic, or a placebo on postoperative pain in maxillary molar teeth with symptomatic apical periodontitis. Design: A randomized, controlled trial. Methods: Population: A total of 51 patients with moderate-to-severe maxillary molar tooth pain who have undergone a root canal treatment. Intervention: Preoperative administration of either an antihistamine or an analgesic. Control: Versus placebo Outcomes: Reduction in postoperative pain? The data were analyzed with chi-square, one-way analysis of variance (ANOVA) and least significant difference (LSD) post-hoc tests. Results: At days 1 and 3, preoperative administration of the antihistamine and analgesic resulted in lower pain levels than the placebo. At days 5 and 7, however, while preoperative administration of the antihistamine still resulted in less pain than the placebo, there was no significant difference between the analgesic and placebo (P>0.05). Conclusion: Within the limitations of the present study, the preoperative administration of an antihistamine can be beneficial in reducing the postoperative pain of endodontic treatments.
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Affiliation(s)
- Hakan Arslan
- Department of Endodontics, Erzurum Atatürk University School of Dentistry, Erzurum, Turkey
| | - Eyüp Candaş Gündoğdu
- Department of Endodontics, Erzurum Atatürk University School of Dentistry, Erzurum, Turkey
| | - Meltem Sümbüllü
- Department of Endodontics, Erzurum Atatürk University School of Dentistry, Erzurum, Turkey
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Arslan H, Seckin F, Kurklu D, Karatas E, Yanikoglu N, Capar ID. The effect of various occlusal reduction levels on postoperative pain in teeth with symptomatic apical periodontitis using computerized analysis: a prospective, randomized, double-blind study. Clin Oral Investig 2016; 21:857-863. [PMID: 27129585 DOI: 10.1007/s00784-016-1835-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 04/24/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the effect of various occlusal reduction levels on the postoperative pain in teeth diagnosed as symptomatic apical periodontitis by using a computerized analysis system. MATERIALS AND METHODS Thirty-nine molar teeth with symptomatic apical periodontitis were included. After the root canal preparation and filling was performed, the subjects were divided into three groups according to the level of occlusal reduction determined by using T-Scan (T-Scan III for Windows, Tekscan Inc., South Boston, MA) as follows: (1) no reduction (control), (2) semi-reduction, and (3) full-reduction groups. Preoperative and postoperative pain levels using visual analogue scale, percussion pain, and analgesic intake were recorded for each subject. The data were evaluated statistically using two-way analysis of variance and Holm-Sidak post hoc tests at a 95 % confidence level (P = 0.05). RESULTS There was no significant difference between the groups in terms of occlusal reduction (P > 0.005). CONCLUSION Within the limitation of the present study, there were no significant differences among the no reduction, semi-reduction, and full-reduction groups at 1, 3, 5, and 7 days in terms of postoperative pain levels. CLINICAL RELEVANCE Occlusal reduction, determined using a computerized analysis system, did not influence the postoperative pain in teeth diagnosed as symptomatic apical periodontitis.
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Affiliation(s)
- Hakan Arslan
- Department of Endodontics, Faculty of Dentistry, Ataturk University, Erzurum, 35620, Turkey.
| | - Fatih Seckin
- Department of Endodontics, Faculty of Dentistry, Ataturk University, Erzurum, 35620, Turkey
| | - Duygu Kurklu
- Department of Prosthodontics, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - Ertugrul Karatas
- Department of Endodontics, Faculty of Dentistry, Ataturk University, Erzurum, 35620, Turkey
| | - Nuran Yanikoglu
- Department of Prosthodontics, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - Ismail Davut Capar
- Department of Endodontics, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
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Mokhtari F, Yazdi K, Mahabadi AM, Modaresi SJ, Hamzeheil Z. Effect of Premedication with Indomethacin and Ibuprofen on Postoperative Endodontic Pain: A Clinical Trial. IRANIAN ENDODONTIC JOURNAL 2016; 11:57-62. [PMID: 26843879 PMCID: PMC4731535 DOI: 10.7508/iej.2016.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 07/28/2015] [Accepted: 11/21/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Post-endodontic pain is one of the main problems for both patients and dentists. The purpose of this study was to compare the effectiveness of premedication with indomethacin and ibuprofen for management of postoperative endodontic pain. METHODS AND MATERIALS In this clinical trial, mandibular molars with irreversible pulpitis were endodontically treated in 66 patients. The medicines were prepared similarly in the form of capsules containing 400 mg ibuprofen (group A), 25 mg indomethacin (group B) and placebo (group C). The patients were given one capsule 1 h before the start of treatment. Patients recorded their pain measured by a visual analogue scale (VAS) at medication time, during treatment and 8, 12 and 24 h after treatment. The data were analyzed using the chi-square, repeated measures ANOVA, paired t-test, Tamhane and Pearson correlation coefficient. RESULTS Ibuprofen and indomethacin significantly reduced the postoperative pain in comparison with placebo during treatment and 8 h after treatment; however, there were no significant differences between them 12 and 24 h after treatment. CONCLUSION Premedication with ibuprofen and indomethacin can effectively control short term post-operative pain; the lower incidence of side effects and greater analgesic power of ibuprofen make it a superior choice.
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Affiliation(s)
- Fatemeh Mokhtari
- Department of Endodontics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | | | - Seyed Jalil Modaresi
- Department of Endodontics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Tabrizizadeh M, Rasti M, Ayatollahi F, Mossadegh MH, Zandi H, Dehghan F, Mousavi Z. Antimicrobial Activity of Calcium Hydroxide and Betamethasone on Enterococcus faecalis; An in vitro Assessment. IRANIAN ENDODONTIC JOURNAL 2015. [PMID: 26213541 PMCID: PMC4509127 DOI: 10.7508/iej.2015.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Calcium hydroxide (CH) is one of the most common intracanal medications. Corticosteroids (CS) are used in endodontics because of their anti-inflammatory activity. This study aimed to evaluate the antimicrobial effect of CH+betamethasone and CH+saline against Enterococcus faecalis (E. faecalis) using agar diffusion test and measuring the microbial zone of inhibition (ZOI). METHODS AND MATERIALS Four plates containing Mueller-Hinton broth and E. faecalis culture media, were prepared. In each plate, 5 holes (5×3 mm) were created and a creamy mixture of CH+betamethasone was inserted into the holes (10 holes for each material). Two holes with ampicillin disks and two empty holes were used as negative and positive controls, respectively. Plates were incubated for 24 h and then the diameter of microbial ZOI was measured. The pH of each mixture was measured by pH meter. Data were analyzed using the Mann-Whitney U test. RESULTS The mean diameter of ZOI for CH+betamethasone and CH+saline was 3.4 and 3 mm, respectively. The difference was not significant (P=0.143). The pH was 12.5 for CH+saline and 12.3 CH+betamethasone, respectively. CONCLUSION The mixture of CH+betamethasone had good antimicrobial effects against E. faecalis. Further studies are needed to confirm the value of this mixture in clinical settings.
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Affiliation(s)
- Mahdi Tabrizizadeh
- Department of Endodontics, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Fatemeh Ayatollahi
- Department of Endodontics, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Hengameh Zandi
- Department of Pathobiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Farzad Dehghan
- Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zohreh Mousavi
- Medical Information and Library Science, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Root canal therapy reduces multiple dimensions of pain: a national dental practice-based research network study. J Endod 2014; 40:1738-45. [PMID: 25190605 DOI: 10.1016/j.joen.2014.07.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 06/13/2014] [Accepted: 07/11/2014] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Initial orthograde root canal therapy (RCT) is used to treat dentoalveolar pathosis. The effect RCT has on pain intensity has been frequently reported, but the effect on other dimensions of pain has not. Also, the lack of large prospective studies involving diverse groups of patients and practitioners who are not involved in data collection suggest that there are multiple opportunities for bias to be introduced when these data are systematically aggregated. METHODS This prospective observational study assessed pain intensity, duration, and its interference with daily activities among RCT patients. Sixty-two practitioners (46 general dentists and 16 endodontists) in the National Dental Practice-Based Research Network enrolled patients requiring RCT. Patient-reported data were collected before, immediately after, and 1 week after treatment using the Graded Chronic Pain Scale. RESULTS The enrollment of 708 patients was completed over 6 months with 655 patients (93%) providing 1-week follow-up data. Before treatment, patients reported a mean (± standard deviation) worst pain intensity of 5.3 ± 3.8 (0-10 scale), 50% had "severe" pain (≥ 7), and mean days in pain and days pain interfered with activities were 3.6 ± 2.7 and 0.5 ± 1.2, respectively. After treatment, patients reported a mean worst pain intensity of 3.0 ± 3.2, 19% had "severe" pain, and mean days in pain and days with pain interference were 2.1 ± 2.4 and 0.4 ± 1.1, respectively. All changes were statistically significant (P < .0001). CONCLUSIONS RCT is an effective treatment for patients experiencing pain, significantly reducing pain intensity, duration, and related interference. Further research is needed to reduce the proportion of patients experiencing "severe" postoperative pain.
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Mititelu Tartau L, Popa EG, Lupusoru RV, Lupusoru CE, Stoleriu I, Ochiuz L. Synergic Effects of Pregabalin-Acetaminophen Combination in Somatic and Visceral Nociceptive Reactivity. Pharmacology 2014; 93:253-9. [DOI: 10.1159/000362649] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 04/03/2014] [Indexed: 11/19/2022]
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Atkinson TJ, Fudin J, Jahn HL, Kubotera N, Rennick AL, Rhorer M. What's New in NSAID Pharmacotherapy: Oral Agents to Injectables. PAIN MEDICINE 2013; 14 Suppl 1:S11-7. [DOI: 10.1111/pme.12278] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Noguera‐Gonzalez D, Cerda‐Cristerna BI, Chavarria‐Bolaños D, Flores‐Reyes H, Pozos‐Guillen A. Efficacy of preoperative ibuprofen on the success of inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a randomized clinical trial. Int Endod J 2013; 46:1056-62. [DOI: 10.1111/iej.12099] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 02/18/2013] [Indexed: 11/28/2022]
Affiliation(s)
- D. Noguera‐Gonzalez
- Endodontic Postgraduate Program and Basic Sciences Laboratory Faculty of Dentistry Universidad Autónoma de San Luis Potosí San Luis Potosí México
| | - B. I. Cerda‐Cristerna
- Endodontic Postgraduate Program and Basic Sciences Laboratory Faculty of Dentistry Universidad Autónoma de San Luis Potosí San Luis Potosí México
| | - D. Chavarria‐Bolaños
- Endodontic Postgraduate Program and Basic Sciences Laboratory Faculty of Dentistry Universidad Autónoma de San Luis Potosí San Luis Potosí México
| | - H. Flores‐Reyes
- Endodontic Postgraduate Program and Basic Sciences Laboratory Faculty of Dentistry Universidad Autónoma de San Luis Potosí San Luis Potosí México
| | - A. Pozos‐Guillen
- Endodontic Postgraduate Program and Basic Sciences Laboratory Faculty of Dentistry Universidad Autónoma de San Luis Potosí San Luis Potosí México
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