Study on Postendodontic Pain

Single-dose premedication of oral diclofenac potassium or prednisolone attenuates immediate postendodontic pain, suggests study published in the Journal of Endodontics.

Study Overview

This prospective, randomized, double-blind clinical trial investigated the impact of diclofenac potassium, prednisolone, and placebo as oral premedication on postendodontic pain and pulpal interleukin (IL)-8 expression in patients with irreversible pulpitis.

Methodology

Thirty-six patients undergoing conventional endodontic treatment were assigned into one of 3 groups (n = 12). Pulpal blood samples were taken after access cavity preparation and stored until they were analyzed using enzyme-linked immunosorbent assay for quantification of IL-8. Postendodontic pain was scored using the visual analogue scale. Outcome data were statistically analyzed using:

• One-way analysis of variance
• Kruskal-Wallis
• Friedman's
• Dunn's
• Chi-square
• Fisher's exact tests
• Spearman's correlation coefficient

The significance level (α) was set at 0.05.

Results

Apart from preoperative pain scores, all groups had similar baseline characteristics (P > .05). Immediate postendodontic pain scores had a significant difference between all groups (P < .05) where the placebo group showed the highest score.

There was no significant difference between all groups at 6 and 12 hours postoperatively (P > .05). Furthermore, there was no significant difference in the incidence of postendodontic pain and in mean IL-8 levels between the 3 groups (P > .05). The only impact the premedications had was on the immediate postendodontic pain intensity, and they had no influence on the later time points, incidence of postendodontic pain, or pulpal IL-8 levels.

Reference

Soliman AA, Ezzat KM, Shaker OG, Abouelenien SS. Influence of Diclofenac Potassium versus Prednisolone on Postendodontic Pain and Pulpal Interleukin-8 Expression in Symptomatic Irreversible Pulpitis Cases: A Randomized Placebo-controlled Trial. J Endod. 2024 Sep;50(9):1213-1220. doi: 10.1016/j.joen.2024.05.019. Epub 2024 Jun 24. PMID: 38925367.