Postoperative Pain Clinical Trial
Official title:
A Comparative Evaluation of Effect of Dexamethazone on Postendodontic Pain and Success of Inferior Alveolar Nerve Block in Mandibular Molars With Symptomatic Irreversible Pulpitis
A Comparative Evaluation of the effect of pretreatment dexamethasone versus placebo on post-endodontic pain and success of inferior alveolar nerve block in Mandibular molars with symptomatic Irreversible Pulpitis: A Blinded Randomized Clinical Trial Therapeutic study
Participants, Interventions and Outcome
Setting:
Patients are of the clinic of endodontics at the faculty of oral and dental medicine, Cairo
University, Urban area, Cairo governorate, Egypt.
- The dental Unit is Adec 200 U.S.A.
- The x-ray Machine is ViVi, S.r.I, Italy
- The x-ray films are Kodac, speed D, size 2.
- The operators are master degree students in the department of Endodontics.
- No dental assistant
- Time: 2017-2016
Procedure steps:
1. Patients are asked to rate the pain level on numerical rating scale before the
administration of drug to get the baseline record for the pain preoperatively.
2. Thirty minutes before the endodontic procedure,dexamethasone (0.5 mg) or a placebo will
be administered.Root canal therapy in all cases was completed in a single visit.
3. After explanation of the treatment procedures (according to individual needs), the
tooth will be anesthetized by an inferior alveolar nerve block (1.8 ml mepivacaine
hydrochloride 2% 1: 100,000 epinephrine) using a side loading aspirating syringe and
27-gauge long needle.
4. At 15-minutes post injection, access cavity will be performed using round bur size 4
and endo-z bur and the pain is recorded .
5. Tooth is then isolated using rubber dam to prevent introduction of saliva and Bactria
from the oral cavity.
6. Checking the patency of the canal with K- file size 10 taper 0.02, extirpation of pulp
with H-file size 15 taper 0.02 with recording the pain.
7. Cleaning and shaping will be performed with a hybrid technique using hand K-files and
rotary files for all teeth.
8. Irrigation will be performed with 2.5% NaOCl after each instrument in all cases. At the
end of instrumentation, the final irrigation will made by saline.
9. After drying the canals with sterile paper points, they will be coated with AD-Seal
sealer and obturated with gutta-percha using the lateral condensation technique.
10. The tooth will be then temporized by using cavit temporary filling and reduced from
occlusion.
11. A rescue medication (ibuprofen) will be prescribed and the patients will be instructed
to take it only if they experienced severe pain postoperatively. If rescue medication
will be taken within the 48 hours after the treatment, then the patient will be
excluded from the study.
Patients will be asked to make a mark on the point that represents level of perceived pain.
(before the commencement of any treatment [baseline score]; at access and pulp extirpation,
immediately after treatment completion; and 6, 12, 24, and 48 hours after the commencement
of treatment). All subjects will be recalled after 2 days to return the pain diary and for a
clinical evaluation.
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