Adjunctive Periapical Dexamethasone Infiltration and 24-Hour Pain Following Single-Visit Root Canal Treatment

Abstract

Background: Pain following root canal obturation can compromise early patient comfort. Anti-inflammatory treatment is one strategy for controlling the acute periradicular response. This study evaluated whether a single periapical dexamethasone infiltration, added to postoperative ibuprofen, was associated with less pain at 24 hours than ibuprofen alone.

Methods: In this comparative clinical study, 128 patients aged 16–45 years with asymptomatic non-vital premolars and no periapical radiolucency were allocated by lottery into two equal groups. All teeth received single-visit root canal treatment using step-back preparation and cold lateral condensation. Group A received adjunctive periapical dexamethasone infiltration and ibuprofen 400 mg three times daily; Group B received the same ibuprofen regimen without dexamethasone. Presence of pain was evaluated 24 hours later using a visual analogue scale. The dexamethasone dose and study dates require verification against original records.

Results: Pain was reported by 6/64 (9.4%) in Group A and 16/64 (25.0%) in Group B (reported p=0.019). The absolute difference in pain incidence was 15.6 percentage points; the unadjusted risk ratio was 0.38. Pain was absent in 58/64 (90.6%) and 48/64 (75.0%) patients, respectively.

Conclusion: Adjunctive periapical dexamethasone infiltration was associated with a lower incidence of reported pain at 24 hours than ibuprofen alone in this selected cohort.