Pharmacological Management of Acute Endodontic Pain

Khan, Asma; Diogenes, Aníbal

doi:10.1007/s40265-021-01564-4

Cited by 6 publications

(4 citation statements)

References 152 publications

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“…The potential interest in various NSAIDs for biofilm control is growing in the scientific community, since various studies show that they have good antimicrobial and antifungal activity, which could be of interest in repurposing these well‐tolerated drugs, as complementary or alternatives therapies for infections related to biofilms (Lagadinou et al, 2020; Paes Leme & da Silva, 2021). Sodium DC is a commonly prescribed NSAID for the treatment of acute pain and inflammation in endodontic infections (Khan & Diogenes, 2021; Zanjir et al, 2020). Its mechanism of action relies primarily on the nonselective inhibition of enzyme cyclooxygenase, which is responsible for the metabolism of arachidonic acid into different bioactive by‐products such as thromboxane A2, prostacyclin, and prostaglandins (Lane, 1997).…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial potential of new diclofenac hydrogels for disinfection in regenerative endodontics: An in vitro and ex vivo study

et al. 2022

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Aim: There is a need to explore new alternatives for root canal disinfection in regenerative endodontics, since the current strategies are far from ideal. Currently, the potential use of diclofenac (DC) is being investigated for controlling root canal infections. The objective was to evaluate the antimicrobial efficacy of novel DC-based hydrogels (DCHs) against polymicrobial biofilms grown in radicular dentine and root canals and to compare results with triantibiotic (TAH) and diantibiotic (DAH) hydrogels, and calcium hydroxide (Ca[OH] 2 ). Methodology: The in vitro antimicrobial activity of intracanal medicaments was evaluated against 3-week-old polymicrobial root canal biofilms grown on human radicular dentine. Dentine samples were obtained and randomly divided into the study groups (n = 4/group): (1) 1 mg/ml TAH; (2) 1 mg/ml DAH; (3) 5% diclofenac (DCH); (4) 2.5% DCH; (5) 1.25% DCH; (6) 1 mg/ml DAH + 5% DCH; (7) Ca(OH) 2 paste; (8) positive control. The microbial viability, in terms of percentage of intact cell membranes, was assessed after 7 days by confocal scanning laser microscopy (CSLM). The ex vivo efficacy of intracanal medications was evaluated in root canals infected with a polymicrobial suspension. Intracanal microbiological samples at baseline (S1) and 7 days post-treatment (S2) were taken; microbial quantification and cell viability were assessed by quantitative polymerase chain reaction (qPCR) and flow cytometry (FC). The mean Log 10 of bacterial DNA copies in root canal samples before (S1) and the Log 10 reduction of DNA copies S1-S2 in qPCR were recorded. The absolute value of total cells stained, and the percentage reduction of intact membrane cells after treatment (S1-S2), were analysed by FC. Global comparison was done using the Kruskal-Wallis test, whilst the Mann-Whitney U test was used for pair-by-pair comparison.Results: Confocal scanning laser microscopy analysis indicated that the greatest effectiveness was obtained with 5% DCH, showing significant differences with respect to the other groups (p < .001). In root canals, the highest Log 10 DNA reduction S1-S2 was obtained with 5% DCH and TAH, with no differences between them.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial potential of new diclofenac hydrogels for disinfection in regenerative endodontics: An in vitro and ex vivo study

et al. 2022

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“…Patient can present in emergency cases with swelling and pain in between appointments. When the inter-appointment emergency arises, proper diagnosis and active therapy is needed to succeed in resolution of symptoms 6 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of Calcium Hydroxidea and Triple Antibiotic Paste on Inter-Appointment Endodontic Pain

Muneer¹,

Choudhry²,

Waris³

et al. 2023

PJMHS

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Background: Endodontic pain is related to inflammatory reactions in the tissues correlated to the damage, and the nature of damage. Inter-appointment pain is correlated to the instrumentation, irrigation and all the other procedures done during appointments. Triple antibiotic paste can be more effective intacanal medicament than calcium hydroxide. But there was a need to confirm its effectiveness. Aim: To compare the effect of calcium hydroxide and triple antibiotic on inter-appointment endodontic pain. Methods: This randomized controlled trial was conducted in the Department of Operative Dentistry, PMC Dental Institute, Faisalabad Medical University, Faisalabad for four months. Sixty cases were enrolled by using Non-probability, consecutive sampling and were divided randomly in two groups. In group 1, triple antibiotic paste was placed for inter-appointment pain. In group 2, calcium hydroxide was placed. After one week, pain was observed. Data was analyzed in SPSS 25. Results: In patients who received triple antibiotics paste, the mean age of patients was 36.90±9.49 years. In patients who received calcium hydroxide, the mean age of patients was 34.83±10.32 years. In patients who received triple antibiotics paste, there were 15(50%) males and 15(50%) females. In patients who received calcium hydroxide, there were 16(53.3%) males and 14 (48.7%) females. In patients who received triple antibiotics paste, the mean pain score was 0.90±1.88. In patients who received calcium hydroxide, the mean pain score was 2.83 ± 3.07. In patients who received triple antibiotics paste, there were 6 (20%) patients who had pain while 24(80%) patients did not report about pain. In patients who received calcium hydroxide, there were 15 (50%) patients who had pain while 15(50%) patients did not report about pain. Conclusion: Triple antibiotic paste was found to be more effective in relieving pain than calcium hydroxide. Key words: Calcium hydroxide, triple antibiotic paste, inter-appointment endodontic pain, visual analogue scale

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“…Nonsteroidal anti-inflammatory agents and steroids have been used to interfere with inflammation and to prevent or stop endodontic pain [ 7 ].…”

Section: Introductionmentioning

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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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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Pharmacological Management of Acute Endodontic Pain

Cited by 6 publications

References 152 publications

Antimicrobial potential of new diclofenac hydrogels for disinfection in regenerative endodontics: An in vitro and ex vivo study

Antimicrobial potential of new diclofenac hydrogels for disinfection in regenerative endodontics: An in vitro and ex vivo study

Comparison of Calcium Hydroxidea and Triple Antibiotic Paste on Inter-Appointment Endodontic Pain

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

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