Background/Aim: Effective management of endodontic pain presents a continuing challenge. This study evaluated the use of a preoperative, single dose of steroidal anti-inflammatory (SAID) drug given through various routes for the prevention and control of post-endodontic pain.
Materials and Methods: In this randomized placebo controlled clinical trial 100 patients were randomly assigned to 5 groups and subgroups, Placebo and Dexamethasone given through oral, intramuscular, supraperiosteal and intraligamentary routes. The medications were administered 1 h before the start of standard endodontic treatment. Postoperative pain was assessed after 6, 12, and 24 h by using a visual analogue scale (VAS).
Results: Based on student t-test analysis, the outcome showed that post operatively, percentage reduction of preoperative pain was significantly more with preoperative administration of steroids than placebo irrespective of the route of administration (P<0.05). Also, oral administration of dexamethasone resulted in significantly more percentage of reduction in preoperative pain as compared to other routes after 24 h (P<0.05).
Conclusions: This study suggested that a preoperative administration of SAID resulted in significant less post-operative endodontic pain at all time-intervals. Preoperative oral administration of Dexamethasone performed best in reducing pain post operatively. Further studies are needed to evaluate the applicability of these finding in other clinical conditions, single versus multiple visit endodontic treatment models or utilizing other drug regimens.

Keywords: Dexamethasone, Intramuscular, Intraligamentary, Oral, Post-operative pain, Root canal treatment.