Abstract
Introduction
Patients without a dentist or access to care may present to emergency rooms with pain.
They are often prescribed medications until they can be treated. There are no studies
to show if emergency endodontic debridement is better than giving medications during
this symptomatic period. The purpose of this prospective, randomized study was to
compare debridement versus no debridement on postoperative pain in emergency patients
with symptomatic teeth, a pulpal diagnosis of necrosis, and a periapical radiolucency.
Methods
Ninety-five patients presenting with moderate to severe pain were analyzed. The patients
were randomly divided into 2 groups: group 1 received anesthesia and endodontic debridement,
and group 2 received anesthesia but no debridement. At the end of the appointment,
all patients were given ibuprofen/acetaminophen. If needed, they could receive an
escape medication. Patients received a 5-day diary to record their pain levels and
medication taken. Success was defined as no or mild postoperative pain and no use
of escape medication. Success data were analyzed using a logistic regression.
Results
Both groups had a decrease in postoperative pain and medication use over the 5 days.
The debridement group had a significantly higher success rate than the no debridement
group. There was no significant difference between the 2 groups with respect to escape
drug use.
Conclusions
Patients receiving debridement or no debridement had a decrease in postoperative pain
over the 5 days. Debridement resulted in a statistically higher success rate, but
there was no significant difference in the need for escape medication.
Key Words
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Article info
Publication history
Published online: January 19, 2016
Identification
Copyright
© 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
