Effect of Dexamethasone Infiltration in Association with Inferior Alveolar Nerve Block with Lidocaine Containing Epinephrine (1:80000) on Postoperative Pain in Teeth with Symptomatic Irreversible Pulpitis

Pain control in dental treatment, especially in root canal treatment, is an important issue. The aim of this study was to investigate the effect of dexamethasone infiltration along with the inferior alveolar nerve block with lidocaine with 1:80000 epinephrine on postoperative pain in posterior teeth with irreversible pulpitis. In this clinical trial, 60 patients with irreversible pulpitis and acute pain in lower molar teeth were selected and randomly divided into two groups. After standard block injection for each patient, buccal infiltration injections of dexamethasone or normal saline solution was performed. Preoperative pain was recorded using visual analogue scale (VAS) from 0 to 10 before treatment, and at 4-, 6-, 12- and 24-hour postoperative intervals. Data were analyzed with independent t-test and chi-squared, Mann-Whitney and Friedman tests (α = 0.05). There were no significant differences between the two groups in age, sex, tooth and pain severity before treatment. Pain in the control group 12 and 24 hours after treatment was significantly less severe than that at 4-hour interval; however, in the dexamethasone group this difference was not significant. By controlling confounding factors, preoperative pain significantly affected the pain after treatment at 4 and 6 hours. Gender affected pain at 12-hour postoperative interval. Buccal infiltration of dexamethasone significantly affected pain at 4- and 6-hour postoperative intervals. Preoperative pain significantly affected pain at 4- and 6-hour postoperative intervals in mandibular molars with irreversible pulpitis.