Endodontic postoperative flare-up: An update

Purpose. Postendodontic pain is one of the problems of root canal therapy. This clinical study aimed to evaluate the effect of infiltration injection of dexamethasone and methylprednisolone on postendodontic pain in patients with necrotic pulp. Methods. A total of 80 volunteers with necrotic pulp teeth were included and assigned to two groups (n = 40). After the administration of local anesthesia and before root canal therapy, in group 1, an infiltration injection of 1 ml of dexamethasone was done and in group 2, an infiltration injection of 1 ml of methylprednisolone was done in the buccal vestibule of each tooth. Patients’ pain was reported using a visual analogue scale at pretreatment and 6, 12, 24, and 48 hours after treatment. Results. There was no significant difference between the two groups receiving dexamethasone and methylprednisolone at pretreatment and 6, 12, 24, and 48 hours after endodontic treatment. Conclusions. Infiltration injection of dexamethasone and methylprednisolone had a significant effect in reducing pain after the endodontic treatment in necrotic pulp teeth, but between 6 and 12 hours, methylprednisolone had significantly more effect on pain relief than dexamethasone. Overall, the use of any of these drugs to reduce postendodontic pain is recommended.

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“…Despite modern root canal treatment methods and new rotary systems, flare-up remains a major problem for all dentists [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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

Yeganegi

Fazelian

Nejad

et al. 2022

Pain Research and Management

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“…First of all, we would like to thank the authors for their letter. As the authors mentioned in their letter, apically extruded debris has been shown to be associated with flare-ups during root canal procedures and the reasons for the same have been detailed in the literature [1]. During mechanical root canal instrumentation, the virulence and number of apically extruded microorganisms are the critical and crucial factors that define the extent of the peri-radicular response.…”

Section: Response To 'Impacts Of Different Nickel-titanium Rotary And...mentioning

confidence: 98%

Response to ‘Impacts of different Nickel–Titanium rotary and reciprocating root canal preparation systems on the amount of apically extruded debris’

2023

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“…(d) Endodontic flare up (e) environmental influence over expression of certain virulent clones (f) host resistance. 5,6 Mechanical preparation of the canals is not enough for the complete removal of bacterial and pulpal insults from the canal system. They harbor the agents which then cause pain before the next appointment.…”

Section: Original Articlementioning

confidence: 99%

Comparison of Endodontic Pain observed with Sodium Hypochloride, Hydrogen peroxide and Norman Saline based Root canal irrigants

Noor¹,

Mujtaba²,

Humayoun³

et al. 2022

Ann Pak Inst Med Sci

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Objective: To compare frequency and intensity of endodontic pain with sodium hypochlorite, hydrogen peroxide and normal saline groups. Method:105 subjects were randomly allocated to 3 study arms. Group A (Sodium Hypochlorite), Group B (Hydrogen Peroxide) & Group C (Normal saline).Data regarding endodontic pain was recorded by asking the patient to mark on the Visual Analogue Scale (VAS) according to the severity of pain on the proforma provided. Results:The minimum Intensity of pain was 0 and maximum was 10 with mean and standard deviation were 3.43 3.576 VAS. Endodontic pain was present in 12/35 (34.3%), 24/35 (68.6%), 30/35 (85%) patients of Group’s A, B, C respectively. Significant difference between groups with respect to Intensity of pain (VAS) was shown by one-way ANOVA. For Group A the Intensity of pain (VAS) was 82.38 4.34 and for Group B, C the Intensity of pain (VAS) were 4.37 3.456 and 6.11 3.197 respectively. Conclusions:Sodium Hypochlorite was much better than Hydrogen peroxide and normal saline in the management of endodontic pain in terms of incidence and intensity.

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Endodontic postoperative flare-up: An update

Cited by 20 publications

References 74 publications

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

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

Response to ‘Impacts of different Nickel–Titanium rotary and reciprocating root canal preparation systems on the amount of apically extruded debris’

Comparison of Endodontic Pain observed with Sodium Hypochloride, Hydrogen peroxide and Norman Saline based Root canal irrigants

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