Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Str, ElManyal, Cairo, 11553, Egypt.
Head Face Med. 2024 Sep 21;20(1):52. doi: 10.1186/s13005-024-00453-x.
The aim of this trial was to evaluate the effect of a preoperative, single dose sublingual fast-dissolving piroxicam (20 mg) compared to placebo on postoperative pain at rest (POP), on biting (POPB) and on percussion (POPer) after single-visit endodontic treatment of asymptomatic mandibular molars with non-vital pulp.
Seventy patients randomly received either piroxicam or placebo 1 h before treatment (n = 35). Patients recorded their pain (POP and POPB) level 6 h, 12 h, 24 h, 48 h, 72 h and 7 days postoperatively using an 11-point numerical rating scale; POPer was assessed after 7 days. Resuce-analgesic intake (RAI) and flare-up incidence (FUI) were recorded. Data were statistically analyzed.
Both groups had similar baseline characteristics (P > 0.05). Piroxicam showed less POP intensity and incidence than placebo at 6, 12 and 24 h, less POPB intensity and incidence at all timepoints, less POPer intensity and incidence and less RAI (p > 0.05), but similar FUI (P > 0.05). A significant rise in pain compared to baseline occurred with placebo from 6 to 72 h for POP and to 7 days with POPB (p > 0.05); such rise was not detected with piroxicam. POPB showed higher pain intensity than POP at all time points (p < 0.05). No swelling or adverse effects occured.
A preoperative single dose of sublingual fast-dissolving piroxicam can be effective in reducing spontaneous pain up to 24 h, stimulated pain up to 7 days, and RAI incidence in asymptomatic mandibular molars with non-vital pulp; it can prevent rise in POP and POPB postoperatively. Stimulated postoperative pain can be more severe and longer lasting than spontaneous pain.
Clinicaltrials.gov ID: NCT03998826 (2019).
本试验旨在评估术前单次舌下速溶吡罗昔康（20mg）与安慰剂相比，对无症状下颌磨牙牙髓非活力治疗单次就诊后静息时（POP）、咬合时（POPB）和叩击时（POPer）疼痛的影响。
70 例患者随机接受吡罗昔康或安慰剂治疗前 1h（n=35）。患者在术后 6、12、24、48、72h 和 7d 时使用 11 分数字评分量表记录疼痛（POP 和 POPB）水平；7d 时评估 POPer。记录解救镇痛剂摄入（RAI）和flare-up 发生率（FUI）。对数据进行统计学分析。
两组基线特征相似（P>0.05）。与安慰剂相比，吡罗昔康组在 6、12 和 24h 时的 POP 强度和发生率较低，各时间点的 POPB 强度和发生率较低，POPer 强度和发生率较低，RAI 较低（p>0.05），但 FUI 相似（P>0.05）。与安慰剂相比，在 6 至 72h 时，POP 出现显著的基线疼痛升高，在 7d 时，POPB 出现显著的基线疼痛升高（p>0.05）；吡罗昔康组未发现这种升高。在所有时间点，POPB 的疼痛强度均高于 POP（p<0.05）。无肿胀或不良反应发生。
术前单次舌下速溶吡罗昔康可有效减轻无症状下颌磨牙牙髓非活力治疗后 24h 内自发性疼痛、7d 内刺激性疼痛和 RAI 发生率；可预防术后 POP 和 POPB 的升高。术后刺激性疼痛可能比自发性疼痛更严重且持续时间更长。
Clinicaltrials.gov ID：NCT03998826（2019 年）。
