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Randomized Clinical Trial of Intraosseous Methylprednisolone Injection for Acute Pulpitis Pain
Khaly Bane1, Emmanuel Charpentier2, François Bronnec3
1Service d'Odontologie Conservatrice et Endodontie, Département d'Odontologie, Faculté de Médecine, Pharmacie et d'Odonto-Stomatologie, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal.
Introduction:
The present study reports the results of a randomized clinical trial comparing local intraosseous methylprednisolone injection and emergency pulpotomy in the management of acute pulpitis on efficacy, safety, and efficiency end points.
Methods:
After providing prior informed written consent, 94 patients consulting for acute irreversible pulpitis pain at university-affiliated teaching hospital dental clinics in Dakar, Senegal were randomly assigned to either the methylprednisolone treatment group (n = 47) or the pulpotomy treatment group (n = 47). Patients were followed up at 1 week and assessed 6 months later to evaluate the therapeutic outcome of their treatment.
Results:
At day 7 the patients in the methylprednisolone group reported less intense spontaneous and percussion pain in the day 0-day 7 period than the patients in the pulpotomy group. Methylprednisolone treatment took approximately 7 minutes (4.6-9.3) less to accomplish than pulpotomy (or about half the time). No difference in the therapeutic outcome was found between the 2 treatment groups at 6 months (all credible intervals span 0).
Conclusions:
This study establishes that methylprednisolone injection for acute pulpitis is relieved by a minimally invasive pharmacologic approach more effectively than by the reference pulpotomy and conserves scarce dental resources (ie, endodontic equipment and supplies, dental surgeon's time).
