Comparison of Post Operative Endodontic Pain in Patients with Irreversible Pulpitis Treated with and Without Dexamethasone.
Overview
- Phase
- Early Phase 1
- Intervention
- Dexamethasone 4mg
- Conditions
- Pain
- Sponsor
- Shoaib Rahim
- Enrollment
- 140
- Primary Endpoint
- post operative pain
- Status
- Not yet recruiting
- Last Updated
- last year
Overview
Brief Summary
Root canal procedure is a common procedure in dentistry. Acute inflammatory response in peri-radicular tissues after root canal treatment is the main cause of post op pain.
Potential Solution: The current study will assess effect of dexamethasone administered as periapical infiltration in reducing post-instrumentation pain.
Research Goal: Pain score of patients treated with dexamethasone infiltration will be less compared to patients treated with NSAIDS alone after canal instrumentation.
Detailed Description
Acute inflammatory response in peri-radicular tissues after root canal treatment is the main cause of post op pain. The peak inflammatory response occurs after 24 - 48 hours of root canal instrumentation. As management of post-endodontic pain is still a challenge for clinicians several drugs which include NSAIDs, acetaminophen, opioids and steroids are used to reduce the inflammatory response. Corticosteroids possess anti-inflammatory efficacy, and they prevent the production and release of inflammatory mediators at the site of tissue injury thus reducing the signs \& symptoms of inflammation such as pain, swelling \& loss of function. Dexamethasone is a potent corticosteroid that has the ability to reduce the production of proinflammatory cytokines. Dexamethasone can be administered orally, or as an intraosseous, intra ligament periapical \& intracanal injection. Dexamethasone is effective in alleviating pain in first 24 hours post endodontic treatment. Previous research on the effect of dexamethasone injection on post-endodontic treatment pain in patients presenting with necrotic pulp treated with single visit endodontic treatment reported 25% post operative pain occurrence and 9% when treated with dexamethasone. Study Goal : The current study will assess effect of dexamethasone administered as periapical infiltration in reducing post-instrumentation pain as compared to the prescription of NSAIDs only. If dexamethasone infiltration is effective in pain relief after endodontic treatment, it can be a useful adjunct in managing patients presenting with acute pulpal pain.
Investigators
Shoaib Rahim
Assistant professor
Foundation University Islamabad
Eligibility Criteria
Inclusion Criteria
- •Patients of age 18-50 years
- •Maxillary molar and premolar teeth
- •Pt diagnosed with irreversible pulpitis with or without apical periodontitis
Exclusion Criteria
- •Teeth with calcified canals.
- •Teeth with incompletely formed apices.
- •Teeth requiring retreatment.
- •Taking analgesics, anti-inflammatory, or tri-cyclic anti-depressants for their medical conditions.
- •Teeth with grade II or III mobility (more than 2 mm)
- •Pregnant patients
- •Pt who are immunocompromised (uncontrolled diabetes mellitus, renal impairment)
Arms & Interventions
Experimental
Participants in this arm will receive routine root canal treatment along with 2.5ml of dexamethasone 4mg/ml peri apical infiltration with a prescription of NSAIDs post operatively.
Intervention: Dexamethasone 4mg
Outcomes
Primary Outcomes
post operative pain
Time Frame: 12 hours, 24 hours and 1 week
The patient's pain response before treatment will be recorded using visual analogue scale 0-10.Pain score of 3 and less than 3 will be categorized as no postoperative pain and score greater than 3 will be categorized as post operative pain.