A Randomized, Double Blinded Clinical Trial to Compare the Effect of Oral Premedication (Diclofenac Potassium or Dexamethasone) on Post-Operative Pain Following Pulpectomy

Authors: Ibrahim Almaazmi H , Abraham SB* , Rawas-Qalaji M and Gorduysus MO

DOI: 10.23880/oajds-16000417

Volume 11, Issue 1

Abstract

Introduction: Post-operative pain following endodontic procedures are often reported by patients. Pain perception is often subjective, varies for different individuals and is influenced by a range of physical and psychological factors. Pain management during and following-root canal treatment can be challenging, and previous literature reports the use of premedication to manage pain. Objective: This double-blinded, randomized clinical trial tested the effectiveness of a single, orally administered preoperative dose of Diclofenac potassium (DFK) or Dexamethasone (DEX) on postoperative pain following pulpectomy in teeth with irreversible pulpitis and symptomatic apical periodontitis. Material and Methods: 73 participants (N=73) with ages ranging from 18 to 60 years were recruited from the emergency clinics at University Dental Hospital Sharjah (UDHS), UAE. Following inclusion and exclusion criteria, participants were divided into 3 groups where either 50 mg DFK, 4 mg DEX or a placebo were given half hour prior to pulpectomy procedure. Participants recorded postoperative pain intensity at 6, 12, and 24 h using a 10-cm visual analogue scale (VAS). Results: A single preoperative dose of 50 mg DFK or 4 mg DEX reduced the incidence and severity of postoperative pain compared to placebo in all patients upto 24 h. Pain intensity data showed DEX consistently outperformed DFK and placebo, with significant differences observed at all-time points. Logistic regression analysis revealed that gender was a significant factor, with females showing higher odds of pain (p < 0.05), while age and tooth type did not significantly affect outcomes. Conclusion: The prevention of post-endodontic pain following endodontic treatment is essential for both patients and physicians. No adverse effects were reported with either medication. DEX emerged as the most effective medication for postoperative pain management.

Keywords: Pulpectomy; Dexamethasone; Diclofenac Potassium; Postoperative Pain

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