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The preoperative administration of corticosteroids significantly reduce the incidence
of postoperative pain after single-visit root canal therapy.
As per a study published in the ' Journal of Endodontics', corticosteroids may be highly useful for the postoperative endodontic pain relief in patients with symptomatic pulpitis encountering single-visit root canal treatment (RCT). Also, the need of rescue treatment was reduced with no drug related side effects.
The main questions addressed while implementing this study revolved around population, intervention, comparator, outcome, timing, study design and setting. These questions were: Which patients with preoperative pain will undergo single-visit nonsurgical endodontic treatment, How effective are corticosteroids compared with other analgesics or placebo in easing postoperative pain and occurrence of adverse events.
Chinni Suneelkumar et al. performed a database search on PubMed/MEDLINE, Scopus, and Cochrane databases to reveal published articles applying the included keywords in different combinations. Manual searching was done, and Clinicaltrials.gov site was also explored. The risk of bias tool was used by 2 independent reviewers to investigate the eligibility for inclusion, extracted data, and assessed quality. Meta-analysis was performed on the pooled effect size.
All in all, the database and manual search identified 481 and 37 citations, respectively. After carefully examining the abstracts and eliminating duplicates, 28 full-text articles were perused. Only 5 articles justified the inclusion criteria; qualitative examination disclosed that 4 studies had an unclear risk of bias, and 1 study had a low risk of bias. As for sample sizes, only 1 study had a sizable sample size, and others had lesser sample sizes. Meta-analysis revealed that Prednisolone administered preoperatively at 6, 12, and 24 hours tapered the incidence of postoperative pain. The patients reported no adverse effects.
Nevertheless, more studies need to be performed with higher sample sizes to
authenticate the conclusions.
Journal of Endodontics
Effect of Preoperative Corticosteroids in Patients with Symptomatic Pulpitis on Postoperative Pain after Single-visit Root Canal Treatment: A Systematic Review and Meta-analysis
Chinni Suneelkumar et al.
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