demeclocycline and Pain--Postoperative

Up to 80% of endodontic patients who report with preoperative pain continue to experience some level of pain following the endodontic procedure. Various classes of drugs have been studied for the management of post-treatment endodontic pain. Since endodontic pain is often associated with chronic inflammation, the presence of bacterial by-products, influx of primed immune cells and activation of the cytokine network and other inflammatory mediators, pain may be reduced by administration of glucocorticoid steroids. The aim of this paper is to review the pharmacology and mechanisms of actions of steroids as well as their indications for endodontics, contraindications, dosages and side-effects.

Topics: Animals; Calcium Hydroxide; Demeclocycline; Drug Combinations; Humans; Pain, Postoperative; Risk Factors; Root Canal Therapy; Steroids; Triamcinolone Acetonide

The aim of this clinical trial was to compare the degree of short term post-operative irritation after application of a triamcinolone/demeclocycyline based or a calcium hydroxide based provisional cement.. A total of 109 patients (55 female and 54 male; mean age: 51 ± 14 years) with primary or secondary dentinal caries were randomly assigned to the two treatment groups of this biomedical clinical trial (phase III). Selection criteria were good systemic health and treated teeth, which were vital and showed no symptoms of pulpitis. Up to three teeth were prepared for indirect metallic restorations, and the provisional restorations were cemented with a triamcinolone/demeclocycyline (Ledermix) or a calcium hydroxide (Provicol) based material. The intensity of post-operative pain experienced was documented according to the VAS (4, 12, 20, 24, and 82 h) and compared to VAS baseline.. A total of 159 teeth were treated (Ledermix: 83 teeth, Provicol: 76 teeth). The minor irritation of the teeth, experienced prior to treatment, was similar in both groups; however, 4 h after treatment this value was significantly higher in the Provicol group than in the Ledermix group (p < 0.005, t-test). After 12 h, the difference was no longer significant. The number of patients taking analgesics for post-treatment pain was higher in the Provicol group (n = 11/53) than in the Ledermix group (n = 3/56).. The patients had no long term post-operative pain experience in both groups. However, within the first hours after cementation the sensation of pain was considerably higher in the Provicol group than in the Ledermix group.

Topics: Adult; Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; Bone Cements; Calcium Hydroxide; Demeclocycline; Dental Caries; Drug Combinations; Female; Humans; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Prospective Studies; Triamcinolone Acetonide

To investigate the relationship of postoperative pain to three different medicaments placed in the root canal after a complete biomechanical debridement of the root canal system in patients presenting for emergency relief of pain.. Two hundred and twenty-three teeth belonging to 221 patients presenting as emergencies to the Royal Dental Hospital of Melbourne were included in the study. Inclusion was limited to patients with a diagnosis of pulp necrosis and acute apical periodontitis. All teeth underwent conventional root canal treatment, which involved the instrumentation to the apices of each canal at the first visit. Canals were instrumented using a stepback technique and hand-files along with irrigants using Milton's (1% sodium hypochlorite) solution followed by 15% EDTAC. The canals were dried and one of the following three medicaments was inserted into the canal in random sequence: Group 1: Ledermix paste (Lederle Pharmaceuticals, Division of Cyanamid, Wolfratshausen, Germany); Group 2: calcium hydroxide paste (Calcipulpe, Septodont, France); and Group 3: no dressing. Before dismissal, the preoperative pain experienced on the previous night was recorded using a visual analogue pain scale. Patients were then instructed to record the degree of pain experienced 4 h after treatment and daily for a further 4 days.. The mean score pain for all three groups was between 42 and 48 prior to treatment being commenced. After 4 days, the pain score for Group 2 was 10, for Group 3 was 7 and for Group 1 was 4. Mean preoperative pain level was 44.4 (of a maximum 100) for all groups, and declined by 50% (to 22.1) after 24 h. Patients in Group 1 (Ledermix) experienced significantly less (P = 0.04) postoperative pain than those in the other two groups. There was no significant difference between Group 2 (calcium hydroxide) and Group 3 (no dressing).. Under the conditions of this study, painful teeth with acute apical periodontitis that had been dressed with Ledermix paste gave rise to less pain than that experienced by patients who had a dressing of calcium hydroxide or no dressing at all. Ledermix is an effective intracanal medicament for the control of postoperative pain associated with acute apical periodontitis, with a rapid onset of pain reduction.

Topics: Anti-Bacterial Agents; Calcium Hydroxide; Calcium Sulfate; Demeclocycline; Dental Cements; Dental Pulp Necrosis; Drug Combinations; Emergency Treatment; Glucocorticoids; Humans; Methylmethacrylates; Pain Measurement; Pain, Postoperative; Periapical Periodontitis; Polyvinyls; Prospective Studies; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Obturation; Single-Blind Method; Toothache; Triamcinolone Acetonide; Zinc Oxide; Zinc Oxide-Eugenol Cement

Topics: Demeclocycline; Dental High-Speed Technique; Drug Combinations; Humans; Pain, Postoperative; Pulpotomy; Root Canal Irrigants; Root Canal Therapy; Toothache; Triamcinolone Acetonide