Comparative evaluation of the effect of prophylactic intraligamentary injection of dexamethasone and piroxicam on postoperative pain in teeth with symptomatic irreversible pulpitis : A randomized controlled trial / Safwa Essam Mohammed Abdelglil ; Supervised Siza Yacoub Zakhary , Maged M.Negm , Fatma Mohammed Saeed

Thesis (M.Sc.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Endodontics

Aim: To assess and compare the efficacy of local intraligamentary injection of glucocorticoids (dexamethasone) and NSAID (piroxicam), on postoperative pain in mandibular molars with symptomatic irreversible pulpitis treated in a single visit with a randomized clinical trial. Methods: Forty-two patients were included. After confirming the diagnosis clinically and radiographically, patients were randomly assigned into three equal groups (n=14). After administration of standard inferior alveolar nerve block, each participant received intraligamentary injection of 0.4 ml of either 8 mg/2 ml dexamethasone (experimental group 1), 20 mg/ml piroxicam (experimental group 2) or 20 mg of mepivacaine HCl 36 mg /1.8 ml + Levonordefrin HCl 0.108 mg/ 1.8 ml (comparator). Standard endodontic treatment was performed in a single visit using MPro files with crown-down technique and 2.5% sodium hypochlorite for irrigation and obturated with modified single cone technique using a resin sealer.The pain was assessed using the Numerical Rating scale (NRS) preoperatively, and postoperatively after 4, 6, 12, 24 and 48 hours. All demographic, baseline and outcome data were collected and statistically analyzed. Results: Results showed that there was no statistically significant difference between the three groups regarding age, gender distribution and pre-operative pain. There was a significant reduction in pain in the three groups, however, there was a statistically significant reduction in postoperative pain intensity in the piroxicam group compared to mepivacaine group at all time intervals

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