CONSORT Randomized Clinical TrialComparative Evaluation of Premedication with Ketorolac and Prednisolone on Postendodontic Pain: A Double-blind Randomized Controlled Trial
Section snippets
Selection of Subjects
Approval of the study protocol and ethical clearance were obtained from the Institutional Review Board, Bapuji Dental College and Hospital, Davangere, India. A patient information form was given to all enrolled participants, and their informed consent was obtained. The study subjects recruited in this triple-blind, parallel, randomized controlled trial were from the pool of patients selected in the Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital.
Sample Size
The
Statistical Analysis
Normality of the data was tested using the Kolmogorov-Smirnov test. Because the data showed normal distribution, parametric tests were used for comparing the means.
Pain experienced by subjects belonging to different drug groups was analyzed using one-way analysis of variance (ANOVA) followed by the Tukey post hoc test. A subgroup analysis between irreversible pulpitis cases and pulpal necrosis cases was performed using the unpaired t test. A comparison of pain (mean VAS scores) within each
Results
There were 42 women and 44 men included in this clinical trial. There were no significant differences between the groups with respect to age, sex, and arch (Table 3). A comparison of pain among the ketorolac, prednisolone, and placebo groups measured by the VAS at different time intervals is shown in Table 4. Preceding endodontic therapy, the baseline pain data showed no significant difference (P > .05) between the 3 premedication groups in both the irreversible pulpitis and pulpal necrosis
Discussion
The present study compared the degree of postendodontic pain in 92 patients undergoing single-visit endodontic therapy with irreversible pulpitis or necrotic pulp after a single pretreatment dose of ketorolac, prednisolone, or placebo. Preemptive analgesia has a proven efficacy in surgical pain models (8). Because the endodontic pain model is different from the surgical pain model, an uncertainty exists in the effectiveness of preemptive anti-inflammatory drugs on endodontic pain. Several
Conclusion
Within the limitations of this study, the present study concludes that a single pretreatment dose of prednisolone has a more sustained effect in reducing postendodontic pain compared with placebo or ketorolac.
Acknowledgments
The authors thank Dr Umesh for his valuable contribution in statistical analysis.
The authors deny any conflicts of interest related to this study.
References (34)
- et al.
Effect of pretreatment dexamethasone on postendodontic pain
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(2009) - et al.
Evaluation of meloxicam (A cox-2 inhibitor) for management of postoperative endodontic pain: a double-blind placebo-controlled study
J Endod
(2003) - et al.
Incidence of postoperative pain after intracanal procedures based on an antimicrobial strategy
J Endod
(2002) - et al.
Evaluation of pretreatment analgesia and endodontic treatment for postoperative endodontic pain
J Endod
(2008) - et al.
Rational use of analgesic combinations
Dent Clin North Am
(2002) - et al.
Effectiveness of prophylactic use of rofecoxib in comparison with ibuprofen on postendodontic pain
J Endod
(2003) - et al.
Pain suppression after pulpectomy with preoperative flurbiprofen
J Endod
(1987) - et al.
Factors associated with endodontic posttreatment pain
J Endod
(1993) - et al.
Local anesthesia strategies for the patient with a “hot” tooth
Dent Clin North Am
(2010) - et al.
The absence of any pre-emptive analgesic effect for non-steroidal anti-inflammatory drugs
Br J Oral Maxillofac Surg
(1996)
Effect of pretreatment prednisolone on postendodontic pain: a double-blind parallel-randomized clinical trial
J Endod
Success rate of single- versus two-visit root canal treatment of teeth with apical periodontitis: a randomized controlled trial
J Endod
Incidence of pain associated with clinical factors during and after root canal therapy. Part 2. Postobturation pain
J Endod
Anti-inflammatory effects of dexamethasone on periapical tissues following endodontic overinstrumentation
J Endod
Postoperative pain in multiple-visit and single-visit root canal treatment
J Endod
Incidence of postoperative pain after single- and multi-visit endodontic treatment in teeth with vital and non-vital pulp
Eur J Dent
Preoperative and operative factors associated with pain after the first endodontic visit
Int Endod J
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