Efficacy and Safety of Postoperative Medications in Reducing Pain after Nonsurgical Endodontic Treatment: A Systematic Review and Network Meta-analysis

Zanjir, Maryam; Sgro, Adam; Lighvan, Nima Laghapour; Yarascavitch, Carilynne; Shah, Prakesh S.; Costa, Bruno R. da; Azarpazhooh, Amir

doi:10.1016/j.joen.2020.07.002

Cited by 22 publications

(10 citation statements)

References 53 publications

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“…Standard medication strategies should be applied to reduce postoperative pain (Zanjir et al . 2020). Systemic antibiotics have the ability to reduce infection (Hammarstrom et al .…”

Section: Clinical Proceduresmentioning

confidence: 99%

European Society of Endodontology position statement: Surgical extrusion, intentional replantation and tooth autotransplantation

et al. 2021

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“…Standard medication strategies should be applied to reduce postoperative pain (Zanjir et al . 2020). Systemic antibiotics have the ability to reduce infection (Hammarstrom et al .…”

Section: Clinical Proceduresmentioning

confidence: 99%

European Society of Endodontology position statement: Surgical extrusion, intentional replantation and tooth autotransplantation

et al. 2021

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“…(23) Thirty percent of it is released after the first 24 hours, and the remaining 70% is released by the end of 14 weeks. Zanjir et al (2020), in their systematic review and network meta-analysis, stated that corticosteroids were ineffective in cases of necrotic pulp and did not reduce pain, which contradicted some earlier studies. They also concluded that steroids could induce immunosuppression at high doses and longer durations.…”

Section: Usages Of Steroids In Dentistrymentioning

confidence: 87%

“…Therefore, they should be considered only when other anti-inflammatory drugs have been proven useless. (24) Combination of Ledermix and calcium hydroxide Schroeder advocated the use of Ledermix in conjunction with calcium hydroxide for the management of necrotic teeth with an open apex. Ledermix paste and calcium hydroxide (1:1) have also been used to disinfect root canals and to treat pulp necrosis, as well as for apexification of open apices and treatment of tooth perforations, large periapical lesions, inflammatory root resorption, and inflammatory periapical bone resorption.…”

Section: Usages Of Steroids In Dentistrymentioning

confidence: 99%

Steroid as an Intracanal Medicament: An Advanced Review

Kar

Varghese

Agrawal

et al. 2021

J Res Dent Maxillofac Sci

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Post-endodontic treatment pain is a major problem in dentistry. Around 80% of patients who present with preoperative pain due to endodontic treatment continue to experience the pain of some level following endodontic therapy. This pain, mostly linked to chronic inflammation, is due to bacterial toxins that signal the ingress of immune cells followed by the activation of various cytokines and inflammatory mediators. Countless classes of drugs have been studied to resolve this challenge. Glucocorticoids have been in use for more than fifty years owing to their potent antiinflammatory effects. This paper aims to review the pharmacology and mechanism of actions of steroids as an intracanal medicament considering the indications, contraindications, and side effects.

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“…Consistent with a previous systematic review [ 8 ], corticosteroids were found to be effective in reducing postoperative pain. In contrast, another recent systematic review stated that corticosteroids have a minimal role in reducing postoperative pain [ 42 ]. Significant heterogeneity, a small number of included studies, and timing of corticosteroid administration may help explain this contradiction.…”

Section: Discussionmentioning

confidence: 99%

Effect of premedication on postoperative pain after root canal therapy in patients with irreversible pulpitis: a systematic review and meta-analysis

Gaurav¹,

Sangwan²,

Tewari³

2021

J Dent Anesth Pain Med

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This systematic review aimed to assess the effect of premedication on postoperative pain after root canal treatment in vital teeth. Five electronic databases were searched for randomized clinical trials, and two independent reviewers selected eligible studies, extracted data, and assessed the quality of studies using the Cochrane Risk of Bias tool. Meta-analysis was conducted using the random-effects model, and the pooled effect estimate of the standardized mean difference (SMD) between premedication and placebo was calculated. Subgroup analysis was conducted based on the class and route of the drug. Studies with a high risk of bias were excluded from the sensitivity analysis. Ten trials satisfied the inclusion criteria, of which eight were included in the meta-analysis. Premedication was more effective in reducing postoperative pain than placebo at 6 hours (SMD = −1.00; 95% confidence interval [CI] = −1.33 to −0.66), 12 hours (SMD = −0.80; 95% CI = −1.05 to −0.56), and 24 hours (SMD = −0.72; 95% CI = −1.02 to −0.43). The results of the sensitivity analysis confirmed the findings of the primary analysis. Based on these results, it can be concluded that premedication is effective in reducing postoperative pain in teeth with irreversible pulpitis. However, additional quality studies are required for further validation.

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Efficacy and Safety of Postoperative Medications in Reducing Pain after Nonsurgical Endodontic Treatment: A Systematic Review and Network Meta-analysis

Cited by 22 publications

References 53 publications

European Society of Endodontology position statement: Surgical extrusion, intentional replantation and tooth autotransplantation

European Society of Endodontology position statement: Surgical extrusion, intentional replantation and tooth autotransplantation

Steroid as an Intracanal Medicament: An Advanced Review

Effect of premedication on postoperative pain after root canal therapy in patients with irreversible pulpitis: a systematic review and meta-analysis

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