Malik Sartaj
Senior Resident, Department of Conservative Dentistry and Endodontics.
Anum Maqbool
Post Graduate scholar, Department of Conservative Dentistry and Endodontics.
Rizwan Hamid
Post Graduate scholar, Department of Oral Medicine and Radiology.
Mohd Sajad
Senior Resident, Department of Conservative Dentistry and Endodontics.
Ab Wahid Zargar
Post Graduate scholar, Department of Conservative Dentistry and Endodontics.
Mushtaq Mohamad
Post Graduate scholar, Department of Conservative Dentistry and Endodontics.
Abstract
Aim: To evaluate the effect on postoperative pain in patients with symptomatic irreversible pulpitis, receiving endodontic treatment after pre-treatment with single oral dose of a NSAID, NSAID-Paracetamol combination, Acetamenophen-opoid combination and a single dose steroid in comparison to a placebo.
Materials and methodology: A total of 150 patents divided into 5 Groups who were diagnosed with irreversible pulpit is with periapical periodontits were selected for the study. In Group1 patients were given a NSAID, Aaceclofenac 100mg (Aceclo; Aristo pharmaceuticals) half an hour before procedure. In Group 2 patients were prescribed NSAID-Aetamenophen combination i.e. Aceclofenac 100mg+Paracetamol 325mg (Aceclo P; Aristo Pharmaceuticals).In Group 3 patients were given a single dose of Acetamenophen-opoid combination i.e. Acetamenophen 325mg+Tramadol 37.5mg (Mega Flexon; Aristo Pharmaceuticals).In group 4 patients were advised to take single dose of Prednisolone 50mg (Deltason; Group Pharmaceuticals).In Group 5 patients were given a single oral dose of a placebo i.e. Dextrose gelatin capsule. VAS scores were recorded at four different time interval at 3,8,12 and 24 hrs.
Results: The results of pain intensity (VAS) were computed as the means and standard deviations (SD). The incidence of moderate to severe pain in the experimental groups was lower than that in the placebo control group, and this difference was significant (p<0.05) except with that of Group 4 i.e. steroid (prednisolone) (p>0.05). There was no significant difference between NSAID, NSAID-Acetamenophen and Acetamenophen-Opoid combinations (P > 0.05). Among the four different experimental groups lowest incidence of pain at all four different time intervals was recorded with Group 3 i.e. acetaminophen and opioid combination.
Conclusion: Within the limitations of the study, pretreatment analgesia with single oral dose of Aceclofenac and acetaminophen or Acetamenophen and tramadol before endodontic treatment showed substantial reduction in postoperative pain when compared with Aceclofenac and Prednisolone.
Keywords: post-endodontic pain, irreversible pulpitis, NSAIDs, Acetamenophen, opioid