Eur Endod J. Ahead of Print: EEJ-72792 | DOI: 10.14744/eej.2023.72792

Comparative Evaluation of Analgesic Efficacy of Dexamethasone, Cold Saline (Cryotherapy) and Tramadol Hydrochloride as a Final Irrigant on the Postoperative Pain in Patients with Symptomatic Irreversible Pulpitis -A Double-Blinded Randomized Clinical

Unnati Sanjay Shah¹, Ajay Singh Rao¹, Sharanpriya Sathnoorkar², Suran Pushpa³, Rajeshkrishna Malge⁴, Mounika Veeraiyan², Dikshit Mahendra Solanki^1
1Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital, Vadodara Gujarat, India
²Department of Conservative Dentistry and Endodontics, ESIC Dental College, Karnataka, India
³Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute Ballari, Karnataka, India
⁴Department of Pediatric and Preventive Dentistry, ESIC Dental College, Karnataka, India

Objective: The aim of the study was to evaluate and compare the analgesic efficacy of dexamethasone, cold saline(cryotherapy) and tramadol hydrochloride as a final irrigant on the postoperative pain in patients with Symptomatic Irreversible Pulpits.
Methods: Prior the commencement of the study, Institutional ethical approval and CTRI registration was done. A total of 100 single rooted teeth in 100 patients experiencing pain due to symptomatic irreversible pulpitis requiring single visit endodontic treatment were selected. The pre-operative score was recorded using VAS. After cleaning and shaping of the canal the patients were randomly divided into four groups using SNOSE method: Group A: Final Irrigation with Dexamethasone (4mg/ml) (Zydus Healthcare Ltd. India), Group B: Final Irrigation with Tramadol hydrochloride (50mg/ml) (Radiant Parenterals Ltd, India), Group C: Final Irrigation with Cold saline (2.5°C), Group D: Final Irrigation with Normal saline (Control Group) (Otuska Pharmaceutical India Private Limited, India). After group allocation, the root canals in all the experimental groups were irrigated with 2ml of the respective solutions at rate of 1ml per minute using a 27 Gauge needle coupled with 5 ml syringe keeping needle 2 mm short of the WL. The root canal was dried with sterile paper points and subsequently obturated by single cone obturation technique and was followed by Post endodontic restoration using composite resin in all the groups. The postoperative pain scores (VAS)were recorded telephonically at time intervals of 6hrs and 12hrs, 24hrs. The results were statistically analyzed by ANOVA for mean significant difference among the groups for all dependent variables, intergroup comparison was done by Post Hoc Tukey Test, intragroup comparison was done by Paired t Test.
Results: There was no statistically significant difference in analgesic efficacy among these three experimental groups (Group A, B, and C) Intragroup comparison (within the same group) Group A, B and C had statistically significant differences between the pre-and post-operative pain scores at an interval of 6,12, and 24 hours.
Conclusion: Dexamethasone, Tramadol Hydrochloride, and Cryotherapy have similar analgesic efficacy and also reduce post-operative pain in Symptomatic Irreversible Pulpitis proficiently. (EEJ-2023-05-067)

Keywords: Cryotherapy, dexamethasone, final irrigation, single visit endodontics, symptomatic irreversible pulpitis, tramadol hydrochloride

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