Comparison of the Efficacy of Prophylactic Intraligamentary injection of Piroxicam versus Mepivacaine for management of Post-endodontic pain in posterior teeth Double Blind Randomized Clinical Trial)

Abstract

The parallel, randomized clinical trial was conducted to evaluate the effect of prophylactic intraligamentary piroxicam on post-operative pain in mandibular posterior teeth with irreversible pulpitis and symptomatic apical periodontitis after single visit root canal treatment. Twenty six participants, aged between 25 and 50 years old with no gender predilection, diagnosed with acute irreversible pulpitis and symptomatic apical periodontitis in their mandibular posterior teeth, were included. Each patient had mandibular molar that was experiencing pain on percussion. Patients were randomly assigned into either of these two groups: Experimental group: prophylactic intraligamentary piroxicam or control group: prophylactic intraligamentary mepivacaine. After obtaining profound anesthesia, root canal treatment was performed in a single visit. Patients were instructed to record their pain experienced after endodontic procedure in a pain diary at 4, 8, 12, 24, 48 and then they come back after 7 days to deliver the pain dairy and rate their pain of percussion. Patients were, also, asked to write down the number of analgesic tablets taken. Results showed that the prophylactic administration of intraligamentary piroxicam before single visit root canal treatment statistically significantly decreased post-operative pain intensity compared to control group at 8, 12 24, 48 h. Also, piroxicam group showed statistically significant less pain on percussion after 7 days than mepivacaine group. Moreover, it was found that total number of analgesic tablets taken in piroxicam group was statistically significantly less compared to control.