Effect of Supraperiosteal Injection of Dexamethasone on Interappointment Pain in Teeth with Symptomatic Irreversible Pulpitis: A Comparative Study

Abstract


 
 
 Objective: To compare the effect of supraperiosteal injection of dexamethasone with 2% lidocaine on the frequency of interappointment endodontic pain at different time intervals. Study Design: Prospectivecomparativestudy. Place and Duration of Study: The study was carried out at operative department of Armed Forces Institute of Dentistry, Rawalpindi from 1st October 2019 to 31st March 2020. Materials and Methods: A total of 100 patients presenting to the Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi and giving consent for participation, aged 20-50 years from both genders, presenting with acutely inflamed pulp in their maxillary first molars were selected for this study using convenient sampling technique. The patients were randomly divided into two equal groups of 50 patients with the help of scientific random number table. Endodontic therapy was initiated, pulpectomy canals were prepared with ProTaper Next system, intra-canal dressings of calcium hydroxide were placed and the cavity was restored with Cavit till the next appointment. Group A patients were then injected with dexamethasone at the mucobuccal fold and group B patients were injected with lidocaine used as placebo. Pain was recorded at 48 and 72 hours using the visual analogue scale. Data was analyzed using SPSS 21. Results: The study included equal number of male and females. The mean age of group A was 35 ± 4.5 years while of group B was 33 ± 6.7 years. The results showed that dexamethasone does not reduce pain at 48 and 72 hours compared to the placebo. Conclusion: It is concluded that dexamethasone does not reduce interappointment endodontic pain when compared to a placebo.
 
 

Comparative evaluation of effect of intracanal cryotherapy and corticosteroid solution on post endodontic pain in single visit root canal treatment

“…The literature ( 6 , 7 ) reveals that various experimental and clinical studies have shown it to be effective before, mid-treatment, and after the treatment procedure and that it can be administered via multiple routes. The intracanal administration of Dexamethasone may be regarded as safe because it can be used in lower doses as it easily diffuses from the canal onto the surrounding tooth root’s apex and periapical tissues enabling it to be held in contact for a longer period with the inflamed tissues for better action.…”

“…Alternatively, glucocorticoids also show promise and scope in reducing post-operative pain, which acts by inhibiting the synthesis and release of arachidonic acid and its metabolites, thereby inhibiting the synaptic pain pathways. Dexamethasone is a synthetic form of the glucocorticoid class that has been used through submucosal and supra-periosteal injections to reduce post-treatment swelling and pain following endodontic treatment ( 6 - 7 ). An exhaustive study and meta-analysis conducted by Nath et al .…”

Dexamethasone Increases the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis

“…Some clinical assays have been carried out to determine the effect of dexamethasone on the success of dental anesthesia in patients with SIP, and interesting results have been found [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. The main aim of this systematic review and meta-analytical assessment was to evaluate the effects of the systemic and local administration of dexamethasone on the anesthetic success rate, pain intensity, and adverse effects in patients with SIP.…”

Comparison of the Efficacy of Dexamethasone and Methylprednisolone in Infiltration Injection for Postendodontic Pain in Patients with Necrotic Pulp: A Randomized Controlled Clinical Trial

“…Some studies were done to evaluate the effect of corticosteroid on postendodontic pain in teeth with irreversible pulpitis. Studies by Yavari et al [ 12 ], Aksoy and Ege [ 13 ], Yousaf et al [ 14 ], and Naseri et al [ 15 ] on the effect of injection of corticosteroids on postendodontic pain in teeth with symptomatic irreversible pulpitis showed the effect of corticosteroids on decreasing pain after endodontic treatment.…”