Intraligmentary Dexamethasone in Lower First Molars With Irreversible Pulpitis and Apical Periodontits

Effect of Intraligmentary Dexamethasone on Anesthetic Efficacy of Inferior Alveolar Nerve Block Versus Buccal Infiltratation in Lower First Molars With Irreversible Pulpitis and Apical Periodontits: A Randomized Clinical Trial

Status

UNKNOWN

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT05928611

Enrollment

Registered

2023-07-03

Start date

2023-08-31

Completion date

2024-09-30

Last updated

2023-07-27

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Pulpitis - Irreversible

Keywords

irreversible pulpitis with apical periodontitis

Brief summary

Using intraligmentary dexamethasone to reduce the pain intensity during and after root canal preparation

Detailed description

Aim :asseing the effect of intraligmentary dexamethasone on anesthetic efficacy of inferior alveolar nerve block and buccal infiltratation in lower first molar with irreversible pulpitis and apical periodontits, dexamethasone has antiinflammatory effect so it will improve the efficacy of anathesia and reduce postoperative by inhibition the production of phosopholipase and reduction of prostaglandins synthesis Methods: diagnose the case clinically and readiographically Patients will divide into 3 groups First group will be given inferior alveolar nerve block 4%articaine Hcl1:100 epinephrine Second group will be given inferior alveolar nerve block 4%articaine with intraligmentary dexamethasone Third group will be given buccal infiltratation 4%articaine with intraligmentary dexamethasone After anathesia ,make access cavity and reduce the occulsa surface and make it out of occulsion . Working length determination will be done by apex locator and confirm it by x ray . Mechanical preparation will be done by FANTA files and apply EDTA on files Irrigate the canal by Naocl 2.5٪ Complete the root canal preparation through single visit. Obturate the canal by single cone technique and bioceramic sealer. During procedures , record pain intensity on HP visual scale Follow up the patient after 6,12,24 and 48 hours Describe Ibuprofen 200mg in case of sever pain Conclusion : it's predictable that the intraligmentary dexamethasone will reduce the pain during and after root canal procedures

Interventions

PROCEDUREInferior alveolar nerve block with dexamethasone

Using articaine for inferior alveolar block with intraligmentary dexamethasone

PROCEDUREBuccal infiltratation with dexamethasone

Using articaine for buccal infiltratation with intraligmentary dexamethasone

PROCEDUREInferior alveolar nerve block

Using articaine for injection

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

20 Years to 45 Years

Healthy volunteers

Yes

Inclusion criteria

1. Age between 20-45 years old. 2. Systemically healthy patient (ASA I or II). 3. Lower first molar with: * Preoperative sharp pain. * Slight widening in the periodontal ligament (PDL). * Vital response of pulp tissue to cold pulp tester (ethyl chloride spray).

Exclusion criteria

1. Patients allergic to anesthetics, or dexamethasone (other corticosteroids). 2. Pregnant or nursing females. 3. Patients having significant systemic disorder (ASA III or IV). 4. Hemostatic disorders or anti-coagulant therapy during the last month. 5. Consumption of opioid or non-opioid analgesics or corticosteroids during the last 12 h before treatment. 6. Retreatment cases.

Design outcomes

Primary

Measure	Time frame	Description
Intraoperative pain	During procedure	Efficacy of buccal infiltration anesthesia and inferior alveolar nerve block measured during procedures of root canal treatment using numerical rating scale.It is a line numbered from 0-10 , where pain levels are categorized as follows: 0= no pain, 1-3 = mild pain, 4-6= moderate pain, 7-10= severe pain, 10 being the most intense pain conceivable.And instruct patient to raise his hand if he feels pain to reasse if he needs supplementary anathesia

Secondary

Measure	Time frame	Description
Post-operative pain	After procedure until 48hour	Patient will record the pain on numerical rating scale (6,12,24 &48h)..It is a line numbered from 0-10 , where pain levels are categorized as follows: 0= no pain, 1-3= mild pain, 4-6= moderate pain, 7-10 = severe pain, 10 being the most intense pain conceivable
Number of needed analgesic tablets in case of intolerable pain	After procedure until 48hour	Ibuprofen 200mgm tabs have been described to patient in case of sever pain (above6)

Contacts

Primary ContactWafaa R Elshafaey

wafaa.elshafaey@dentistry.cu.edu.eg00201020773887

Backup ContactMohamed M Abi Elhassan, Phd

0020 111 167 7707

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026