Abstract
Introduction
The acute (symptomatic) apical abscess is characterized by pulp necrosis, rapid onset,
spontaneous pain, percussion pain, pus formation, and tissue swelling. The etiopathology
of acute apical abscesses includes active (lytic) herpesviruses and gram-negative
anaerobic bacteria. The present study examined the potential of valacyclovir, an anti-herpesvirus
agent, and systemic amoxicillin to manage the pain of acute apical abscesses.
Methods
Twenty emergency patients with moderate to severe apical abscess pain received randomly
either amoxicillin (1 g immediate dose followed by 500 mg, 4 times a day, totally
7 days) + valacyclovir (2 g immediate dose followed by 500 mg, twice a day, totally
3 days) (“valacyclovir” group, 10 patients) OR amoxicillin (1 g immediate dose followed
by 500 mg, 4 times a day, totally 7 days) + placebo (“placebo” group, 10 patients).
Daily telephone calls during the 6-day follow-up period assessed pain level on a numeric
rating scale and analgesic intake. The Mann-Whitney and the Friedman statistical tests
analyzed the outcome data.
Results
At the baseline examination, all 10 valacyclovir and 9 placebo patients exhibited
moderate to severe pain and 18 patients needed pain medication. On the first day after
baseline, the valacyclovir group showed 2 patients with moderate/severe pain and 1
patient on pain medication, but the placebo group revealed as many as 8 patients with
moderate/severe pain and 9 patients on pain medication. The difference in pain level
and analgesic usage between the valacyclovir and the placebo group remained statistically
significant during the entire post-baseline study period (P < .05).
Conclusion
The present study points to valacyclovir as a promising adjunctive agent in pain control
with acute apical abscesses.
Key words
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Article info
Publication history
Published online: August 04, 2021
Identification
Copyright
© 2021 American Association of Endodontists.
