Analgesic Efficacy of Corticosteroids Used as Intracanal Solutions to Control Inter Appointment Pain during Root Canal Treatment – A Systematic Review

Patients often associate endodontic treatment with pain. Inter appointment pain is common during endodontic treatment and is due to acute inflammation of the apical periodontal ligament space. Till date, several agents have been employed to manage inter appointment pain by administering them through different routes. All the agents for pain control were administered orally in the past. In order to bypass the unwanted side effects and achieve immediate and effective pain control, local administration was followed by intracanal administration. This systematic review analyzes the effect of intracanal delivery of various steroid solutions and their effectiveness in pain management.
A search was performed in electronic database (i.e. Pubmed Central, Google and Hand Search) till August 2019.All in vivo studies that used intracanal corticosteroids for controlling inter appointment pain during endodontic treatment were selected.The outcome measure was to evaluate the reduction of pain in the inter appointment period after intracanal drug delivery.
Since all the studies included for this review showed high risk of bias, no conclusion could be drawn on intracanal use of corticosteroid solutions for analgesia. Further studies have to be conducted with a proper design, standardization of the drug and appropriate statistical analysis to obtain accurate results.