Endodontic post-treatment pain continues to be one of the main problems that dental professions are faced with. Therefore, pain control during and after endodontic treatment is one of the most important issues in endodontics. The purpose of this clinical trial was to compare postoperative pain relief of dexamethasone (DEX) and mineral trioxide aggregate (MTA) as pulp coverage after pulpotomy in human molars teeth with irreversible pulpitis.
This prospective double-blind study was conducted on 54 patients who had dental pain due to irreversible pulpitis. The standard pulpotomy procedure was performed by the same dentist on all the patients. At the time of cotton pellet placement, patients were randomly divided into three groups; those for whom a sterile dry cotton pellet was used, patients treated with a cotton pellet soaked in MTA and those who were treated with a cotton pellet soaked in DEX. After completion of the treatment, patients received rescue medication every 6 hours for the first day. Postoperative pain was assessed at 6-hour intervals for a period of 24 hours and then every day until day 7 using a visual analogue scale (VAS).
In general, patients treated with MTA suffered the lowest levels of pain at all time intervals. Post-pulpotomy pain was significantly reduced at 18 and 24 hours and from day 2-7 posttreatment in the MTA-treated group. DEX lowered the pain level more than the dry cotton pellet. However, the differences were observed in the mean pain scores of the DEX and dry cotton pellet groups at all time intervals were not found to be statistically significant.
Endodontic treatment in the form of pulpotomy is efficacious in reducing post-treatment pain. Pulp covering with MTA soaked cotton pellet significantly reduces pain intensity in patients with irreversible pulpitis who underwent pulpotomy. These favorable results might help to prevent or decrease postoperative pain severity in these patients.