Effect of Pulpotomy Procedures With Mineral Trioxide Aggregate and Dexamethasone on Post-endodontic Pain in Patients with Irreversible Pulpitis: A Randomized Clinical Trial

Abstract

Objective: Endodontic post-treatment pain continues to be one of the main problems encountered by dental professionals. Therefore, pain control during and after endodontic treatment is one of the most importantissues in endodontics. The purpose of this clinical trial was to compare postoperative pain relief achievedwith dexamethasone (DEX) and mineral trioxide aggregate (MTA) used as pulp coverage after pulpotomy inhuman molars with irreversible pulpitis.Methods: This prospective double-blind study was conducted on 54 patients complaining of dental paindue to irreversible pulpitis. The standard pulpotomy procedure was performed by the same dentist in all patients. At the time of the cotton pellet placement, patients were randomly divided into three groups: those inwhom a sterile dry cotton (DC) pellet was used, patients treated with a cotton pellet soaked in MTA, and thosewho were treated with a cotton pellet soaked in DEX. After completion of the treatment, patients receivedrescue medication every 6 hours for the first day. Postoperative pain was assessed at 6-hour intervals for 24hours, and then every day until day 7 using a visual analog scale.Results: In general, patients treated with MTA suffered the lowest levels of pain at all time intervals. Postpulpotomy pain was significantly reduced at 18 and 24 hours and from days 2 to 7 post-treatment in the MTAgroup. DEX lowered the pain level more than the DC pellet. However, the differences observed in the meanpain scores of the DEX and DC pellet groups at all-time intervals were not statistically significant.Conclusion: Pulpotomy procedures can reduce pain related irreversible pulpitis. Pulpotomy with MTAsoaked cotton pellet significantly reduces pain intensity in patients with irreversible pulpitis.