Evaluation of NSAIDs for treating post-endodontic pain A systematic review

Many endodontic patients believe that post-treatment pain is unavoidable, yet several clinical trials indicate that postoperative pain occurs in only 25–40% of all endodontic patients (1–4). However, post-treatment pain may last up to several days, depending upon peripheral and central mechanisms of hyperalgesia (5–7). Hence, successful management of endodontic pain is an important concern for patients and clinicians. Although many recommendations have been given for the use of analgesics in treating postendodontic pain, no study has used the method of systematic review to analyze clinical endodontic trials and provide an evidence-based recommendation for treatment. The purpose of this study therefore is to systematically review the endodontic literature evaluating the use of non-steroidal anti-inflammatory drugs (NSAIDs) in pain management following endodontic therapy. NSAIDs were selected for several reasons. First, pulpal inflammation and necrosis, and the corresponding periradicular tissue changes cause the release of inflammatory mediators, including prostaglandins, which are involved in the mediation of pain (8). Thus, the rationale for the pharmacological management of postendodontic pain is focused on the reduction of chemical inflammatory mediators that acti-