Comparative evaluation of postoperative pain with different intracanal medicaments – A Systematic Review

Patients as well as clinicians have been apprehensive of pain of endodontic origin for many years1. Pain during root canal treatment can be attributed to inflammation in the periapical tissues due to exudation of irritants from the root canal2. The persistence of microorganism due to improper disinfection of root canal is the most important cause of pain 1. The eradication of microorganism from the root canals is therefore vital during root canal treatment . Thus, an antimicrobial dressing in root canals is advocated after root canal preparation 1.  To evaluate the effectiveness of different intra canal medication in reducing the post operative pain in nonsurgical root canal treatment. The following databases were searched: PubMed CENTRAL, MEDLINE and Cochrane Databases of Systemic Reviews, Bibliographies of Clinical Studies and Reviews identified in the electronic search were analysed for studies published outside the electronically searched journals. Trials were selected if they met the following criteria: Clinical trials or in-vivo studies that evaluated the post operative pain after using different intracanal medicament in patients undergoing root canal treatment. All the studies included, were based on the data extraction and analysis of the studies for quality and publication bias. The primary outcome measure was to evaluate the reduction in post operative pain after using different intra canal medicaments in patients undergoing root canal treatment. The reviews some clinical evidence that use of intra canal medicaments can reduce postoperative pain. There is no enough evidence to prove that calcium hydroxide is effective in reduction of pain. Corticosteroids antibiotic combination and calcium hydroxide combination with chlorhexidine and camphorated paramonochlorophenol were effective in reducing pain.  From this systematic review it can be concluded that, certain intra canal medicaments can be used to reduce postoperative pain during root canal treatment. Most of the studies proved that, corticosteroid antibiotic solution or combination  of calcium hydroxide with other medicine like camphorated paramonochlorophenol or chlorhexidine is effective in reducing post operative pain. There is no evidence that, use of calcium hydroxide is effective in relieving pain. Further clinical trials are required to evaluate the efficacy of intra canal medicaments in reducing postoperative pain.