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A double-blind placebo-controlled, randomised, single centre clinical trial validated by the Institutional Review Board of Ethics Committee at the School of Dentistry, Cairo University to manage post-operative endodontic pain.
Endodontic treatment has been a source of anxiety and fear due to
the association with postoperative pain. It is usually managed by using oral
analgesics such as nonsteroidal analgesics and acetaminophen or in combination
with narcotics/opioids. The present research demonstrates that single dose of
40 mg prednisolone was beneficial for the control of postoperative pain up to
24hrs.
A double-blind placebo-controlled, randomised, single centre clinical trial validated by the Institutional Review Board of Ethics Committee at the School of Dentistry, Cairo University to manage post-operative endodontic pain.
The analysis involved healthy participants with mandibular
molars and symptomatic irreversible pulpitis, radiographically normal
periapical area and no pain on biting or percussion. The sequence generation
and allocation concealment were performed by the independent Centre for
Evidence-Based Dentistry. The allocation
concealment conducted using two tablets of each medication in opaque, sealed,
sequentially numbered containers. Operators and participants were unknowing of
the assigned group at the time of the analysis. Subjects either received 40 mg
Prednisolone or placebo tablets 30 minutes prior to single visit root canal
operation. The 100mm visual analogue scale used to measure the pain at 6, 12
and 24 hours following the treatment. If required postoperative analgesia,
patients obtained a sham capsule. If pain continued, an analgesic was given.
The frequency of postoperative pain at 6, 12 and 24 hours were considered as
the primary endpoint and the rate of analgesic consumption and pain intensity
considered as secondary endpoints. The risk of pain incidence presented by
using the number-needed-to-treat (NNT) and the relative risk reduction (RRR)
and their 95% confidence intervals (CI).
A total of 400 participants were selected for analysis. Out of 400
patients, 398 were included as the two participants were lost to follow-up.
Both groups exhibited similarity in tooth type, mean age, and gender
distribution. The relative risk decline in pain frequency at six, 12, and 24
hours noticed to be 20.31%, 23.39%, and 28.85%, respectively. Individuals received
Prednisolone show less post-obturation pain intensity than placebo at 6, 12 and
24 hours. The relative risk decline in analgesic consumption was 55% and in
sham-capsule consumption was 54%. No adverse effects were reported. The number
needed to treat (NNT) noticed at six, 12 and 24 hours were five, five and four,
respectively.
The preoperative 40 mg prednisolone single dose provides
considerable efficacy for postoperative pain managment up to 24hrs after single
visit root canal treatment.
Evidence-Based Dentistry
Single dose oral prednisolone and post-operative endodontic pain
Analia Veitz-Keenan et al.
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