AIM To establish the effects of submucosal single doses of two medicines on postoperative pain after root canal treatment in mandibular molar teeth with symptomatic irreversible pulpitis. METHODOLOGY In this randomized controlled, double-blind clinical trial, 90 patients with the diagnosis of symptomatic irreversible pulpitis in their mandibular first or second molars were included and randomly divided into three groups (n = 30): a control group that received normal saline and two experimental groups that received a single dose of either tramadol (100 mg 2 mL-1 ) or dexamethasone (8 mg 2 mL-1 ). After local anaesthesia and before treatment, submucosal injections were administered into the mucobuccal fold adjacent to the mandibular molars, and a routine single-visit root canal treatment procedure was performed in all groups. After the root canal treatments, the patients were asked to score their pain level using the Heft-Parker visual analogue scale (0-170 mm) at 6, 12, 24, 48 and 72 h. The experimental groups were compared using one-way anova or Kruskal-Wallis H-test. The groups that were significantly different were compared pairwise using Student's t-test or the Mann-Whitney U-test. The findings were expressed as the mean ± standard deviation or median (min-max). The categorical variables were tested using the chi-square test or Fisher's exact chi-square test, and the results were expressed as counts and percentages. RESULTS At the 6-h and 48-h time intervals, the intensity of pain was significantly less in both the dexamethasone and tramadol groups than in the control group (P < 0.0167). At the end of 12 h, the pain level in the dexamethasone group was significantly less compared to the other groups (P < 0.0167). CONCLUSIONS Pretreatment submucosal dexamethasone and tramadol injections significantly diminished post-treatment endodontic pain of patients with symptomatic irreversible pulpitis following single-visit root canal treatment. However, dexamethasone was more effective than tramadol in pain reduction in the first 12 h.

中文翻译：

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曲马多和地塞米松的粘膜下预处理对有症状的不可逆性牙髓炎的下颌磨牙的牙髓后牙痛的影响：一项随机对照临床试验。

目的探讨粘膜下单剂两种药物对下颌磨牙伴有症状的不可逆性牙髓炎根管治疗后术后疼痛的影响。方法在该随机对照双盲临床试验中，纳入了90例诊断为下颌第一或第二磨牙的症状性不可逆性牙髓炎的患者，并将其随机分为三组（n = 30）：对照组接受生理盐水治疗，两个接受单剂量曲马多（100 mg 2 mL-1）或地塞米松（8 mg 2 mL-1）的实验组。局麻后和治疗前，将粘膜下注射至与下颌磨牙相邻的粘膜颊沟，并在所有组中进行常规的单次就诊根管治疗。根管治疗后，要求患者在6、12、24、48和72小时使用Heft-Parker视觉模拟量表（0-170毫米）对他们的疼痛程度进行评分。使用单向方差分析或Kruskal-Wallis H检验比较实验组。使用Student t检验或Mann-Whitney U检验将显着不同的组进行成对比较。结果表示为平均值±标准偏差或中位数（最小-最大）。使用卡方检验或费舍尔精确卡方检验检验类别变量，结果表示为计数和百分比。结果在6小时和48小时的时间间隔内，地塞米松组和曲马多组的疼痛强度均明显低于对照组（P <0.0167）。在12小时结束时，地塞米松组的疼痛水平明显低于其他组（P <0.0167）。结论一次性粘膜根管治疗后，粘膜下地塞米松和曲马多注射液可显着减轻有症状的不可逆性牙髓炎患者的治疗后牙髓疼痛。然而，在开始的12小时内，地塞米松比曲马多在减轻疼痛方面更有效。