Mrini R, Salamanca-Ramos M, Ledezma P, Pérez AR, Aranguren J, Montecinos J, Utreras E, Pinto-Pardo N. Efficacy of NSAIDs and corticosteroids as premedication for post-endodontic pain management: A systematic review and meta-analysis. J Clin Exp Dent. 2026;18(1):e105-15.

 

doi:10.4317/jced.63455

https://doi.org/10.4317/jced.63455

___

 

References

1. Macfarlane TV, Glenny AM, Worthington HV. Systematic review of population-based epidemiological studies of oro-facial pain. J Dent. 2001;29(7):451-67.
https://doi.org/10.1016/S0300-5712(01)00041-0
PMid:11809323

 

2. Alhilou AM, Al-Moraissi EA, Bakhsh A, Christidis N, Näsman P. Pain after emergency treatments of symptomatic irreversible pulpitis and symptomatic apical periodontitis in the permanent dentition: a systematic review of randomized clinical trials. Front Oral Health. 2023;4:1147884.
https://doi.org/10.3389/froh.2023.1147884
PMid:37920592 PMCid:PMC10618681

 

3. Yang SE, Park YG, Han K, Min JA, Kim SY. Dental pain related to quality of life and mental health in South Korean adults. Psychol Health Med. 2016;21(8):981-92.
https://doi.org/10.1080/13548506.2015.1098781
PMid:26456324

 

4. Virdee SS. Effective Pain Management Strategies in Endodontic Therapy. Dent Update. 2016;43(6):575-6, 8-80, 83-4, 87.
https://doi.org/10.12968/denu.2016.43.6.575
PMid:29148654

 

5. McGillivray A, Dutta A. The influence of laser-activated irrigation on post-operative pain following root canal treatment: A systematic review. J Dent. 2024;144:104928.
https://doi.org/10.1016/j.jdent.2024.104928
PMid:38484867

 

6. Azim AA, Merdad K, Peters OA. Diagnosis consensus among endodontic specialists and general practitioners: An international survey and a proposed modification to the current diagnostic terminology. Int Endod J. 2022;55(11):1202-11.
https://doi.org/10.1111/iej.13816
PMid:35984730 PMCid:PMC9826047

 

7. Abraham D, Singh A, Goyal A. Symptomatic Irreversible Pulpitis Induces Increased Levels of Human NLRP3 in Gingival Crevicular Fluid Compared to Saliva: A Case Control Observational Study. J Endod. 2023;49(11):1480-6.
https://doi.org/10.1016/j.joen.2023.08.013
PMid:37634578

 

8. Barbero-Navarro I, Irigoyen-Camacho ME, Zepeda-Zepeda MA, Ribas-Perez D, Castaño-Seiquer A, Sofian-Pauliuc I. Understanding the Dynamics of Inflammatory Cytokines in Endodontic Diagnosis: A Systematic Review. Diagnostics (Basel). 2024;14(11):1099.
https://doi.org/10.3390/diagnostics14111099
PMid:38893626 PMCid:PMC11171959

 

9. Al-Natour B, Rankin R, McKenna R, McMillan H, Zhang S-D, About I, et al. Identification and validation of novel biomarkers and therapeutics for pulpitis using connectivity mapping. Int Endod J. 2021;54(9):1571-80.
https://doi.org/10.1111/iej.13547
PMid:33964033

 

10. Kahler B, Taha NA, Lu J, Saoud TM. Vital pulp therapy for permanent teeth with diagnosis of irreversible pulpitis: biological basis and outcome. Aust Dent J. 2023;68:(1 Suppl) S110-S122.
https://doi.org/10.1111/adj.12997
PMid:37986231

 

11. Mehrvarzfar P, Abbott PV, Saghiri MA, Delvarani A, Asgar K, Lotfi M, et al. Effects of three oral analgesics on postoperative pain following root canal preparation: a controlled clinical trial. Int Endod J. 2012;45(1):76-82.
https://doi.org/10.1111/j.1365-2591.2011.01950.x
PMid:21902704

 

12. Di Spirito F, Scelza G, Fornara R, Giordano F, Rosa D, Amato A. Post-Operative Endodontic Pain Management: An Overview of Systematic Reviews on Post-Operatively Administered Oral Medications and Integrated Evidence-Based Clinical Recommendations. Healthcare (Basel). 2022;10(5):760.
https://doi.org/10.3390/healthcare10050760
PMid:35627897 PMCid:PMC9141195

 

13. Suresh N, Nagendrababu V, Koteeswaran V, Haritha JS, Swetha SD, Varghese A, et al. Effect of preoperative oral administration of steroids in comparison to an anti-inflammatory drug on postoperative pain following single-visit root canal treatment - a double-blind, randomized clinical trial. Int Endod J. 2021;54(2):198-209.
https://doi.org/10.1111/iej.13416
PMid:32976660

 

14. Eyuboglu TF, Gonenc FI. The effect of pain intensity levels and clinical symptoms on the treatment preferences of patients with endodontically involved teeth: A preliminary cross-sectional study. Eur Oral Res. 2020;54(3):142-7.
https://doi.org/10.26650/eor.20200043
PMid:33543120 PMCid:PMC7837708

 

15. Lages LPdD, Bergamaschi CdC, Lopes LC, da Frota EG, Silva MT, Monte TL, et al. Preemptive oral analgesia with steroidal and nonsteroidal anti-inflammatory drugs in periodontal surgery: a systematic review. Front Pharmacol. 2024;15:1385401.
https://doi.org/10.3389/fphar.2024.1385401
PMid:39076590 PMCid:PMC11285104

 

16. Zimmerman A, Laitman A. Safe Management of Adverse Effects Associated with Prescription Opioids in the Palliative Care Population: A Narrative Review. J Clin Med. 2024;13(10):2746.
https://doi.org/10.3390/jcm13102746
PMid:38792289 PMCid:PMC11121850

 

17. Eslambol Nassaj A, Nekouei AH, Fereidooni R, Kamyabi H, Pardakhty A, Shahravan A. Comparative Efficacy of Analgesics for Pain Relief in Patients with Symptomatic Irreversible Pulpitis Prior to Emergency Endodontic Treatment: A Randomized Controlled Trial. Iran Endod J. 2023;18(4):194-201.

 

18. Wirth T, Lafforgue P, Pham T. NSAID: Current limits to prescription. Joint Bone Spine. 2024;91(4):105685.
https://doi.org/10.1016/j.jbspin.2023.105685
PMid:38159794

 

19. Veitz-Keenan A, Ferraiolo DM. Single dose oral prednisolone and post-operative endodontic pain. Evid Based Dent. 2018;19(1):10-1.
https://doi.org/10.1038/sj.ebd.6401285
PMid:29568015

 

20. Smith EA, Marshall JG, Selph SS, Barker DR, Sedgley CM. Nonsteroidal Anti-inflammatory Drugs for Managing Postoperative Endodontic Pain in Patients Who Present with Preoperative Pain: A Systematic Review and Meta-analysis. J Endod. 2017;43(1):7-15.
https://doi.org/10.1016/j.joen.2016.09.010
PMid:27939729

 

21. Solete P, Ramesh S. Comparative evaluation of various analgesics in reducing pain in irreversible pulpitis. Bioinformation. 2021;17(2):313-9.
https://doi.org/10.6026/97320630017313
PMid:34234390 PMCid:PMC8225598

 

22. Zahlan G, De Clifford-Faugère G, Nguena Nguefack HL, Guénette L, Pagé MG, Blais L, et al. Polypharmacy and Excessive Polypharmacy Among Persons Living with Chronic Pain: A Cross-Sectional Study on the Prevalence and Associated Factors. J Pain Res. 2023;16:3085-100.
https://doi.org/10.2147/JPR.S411451
PMid:37719270 PMCid:PMC10505027

 

23. Carrasco-Labra A, Polk DE, Urquhart O, Aghaloo T, Claytor JW, Jr., Dhar V, et al. Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in adolescents, adults, and older adults: A report from the American Dental Association Science and Research Institute, the University of Pittsburgh, and the University of Pennsylvania. J Am Dent Assoc. 2024;155(2):102-17.
https://doi.org/10.1016/j.adaj.2023.10.009
PMid:38325969 PMCid:PMC10919895

 

24. Hegde V, Shanmugasundaram S, Shaikh S, Kulkarni V, Suresh N, Setzer FC, et al. Effect of Preoperative Oral Steroids in Comparison to Anti-inflammatory on Anesthetic Success of Inferior Alveolar Nerve Block in Mandibular Molars with Symptomatic Irreversible Pulpitis-A Double-blinded Randomized Clinical Trial. J Endod. 2023;49(4):354-61.
https://doi.org/10.1016/j.joen.2023.01.007
PMid:36736586

 

25. Jose J, Teja KV, Palanivelu A, Khandelwal A, Siddique R. Analgesic efficacy of corticosteroids and nonsteroidal anti-inflammatory drugs through oral route in the reduction of postendodontic pain: A systematic review. J Conserv Dent. 2022;25(1):9-19.
https://doi.org/10.4103/jcd.jcd_30_21
PMid:35722072 PMCid:PMC9200178

 

26. Vane JR, Botting RM. Anti-inflammatory drugs and their mechanism of action. Inflamm Res. 1998;47 Suppl 2:S78-87.
https://doi.org/10.1007/s000110050284
PMid:9831328

 

27. Rainsford KD. Ibuprofen: pharmacology, efficacy and safety. Inflammopharmacology. 2009;17(6):275-342.
https://doi.org/10.1007/s10787-009-0016-x
PMid:19949916

 

28. Lockett J, Inder WJ, Clifton VL. The Glucocorticoid Receptor: Isoforms, Functions, and Contribution to Glucocorticoid Sensitivity. Endocr Rev. 2024;45(4):593-624.
https://doi.org/10.1210/endrev/bnae008
PMid:38551091 PMCid:PMC11244253

 

29. Barnes PJ. Glucocorticosteroids. Handb Exp Pharmacol. 2017;237:93-115.
https://doi.org/10.1007/164_2016_62
PMid:27796513

 

30. Smoak KA, Cidlowski JA. Mechanisms of glucocorticoid receptor signaling during inflammation. Mech Ageing Dev. 2004;125(10-11):697-706.
https://doi.org/10.1016/j.mad.2004.06.010
PMid:15541765

 

31. Nath R, Daneshmand A, Sizemore D, Guo J, Enciso R. Efficacy of corticosteroids for postoperative endodontic pain: A systematic review and meta-analysis. J Dent Anesth Pain Med. 2018;18(4):205-21.
https://doi.org/10.17245/jdapm.2018.18.4.205
PMid:30186968 PMCid:PMC6115367

 

32. Shamszadeh S, Shirvani A, Eghbal MJ, Asgary S. Efficacy of Corticosteroids on Postoperative Endodontic Pain: A Systematic Review and Meta-analysis. J Endod. 2018;44(7):1057-65.
https://doi.org/10.1016/j.joen.2018.03.010
PMid:29709296

 

33. Zanjir M, Sgro A, Lighvan NL, Yarascavitch C, Shah PS, da Costa BR, et al. Efficacy and Safety of Postoperative Medications in Reducing Pain after Nonsurgical Endodontic Treatment: A Systematic Review and Network Meta-analysis. J Endod. 2020;46(10):1387-402.
https://doi.org/10.1016/j.joen.2020.07.002
PMid:32668310

 

34. Konagala RK, Mandava J, Pabbati RK, Anupreeta A, Borugadda R, Ravi R. Effect of pretreatment medication on postendodontic pain: A double-blind, placebo-controlled study. J Conserv Dent. 2019;22(1):54-8.

 

35. Tanwir A, Ahmed S, Akhtar H, Wahid U, Shakoor Abbasi M, Ahmed N. Effectiveness of Single Dose Premedication of Piroxicam and Prednisolone on Post Endodontic Pain in One Visit Root Canal Treatment: A Randomized Clinical Trial. Eur Endod J. 2022;7(3):187-92.
https://doi.org/10.14744/eej.2022.24119
PMid:36217645 PMCid:PMC9608131

 

36. Bortoluzzi MC, Reis A. Nonsteroidal Anti-inflammatory Drugs Alone or in Combination With Acetaminophen are Effective and Safe Treatments for Short-Term Pain Control in Nonsurgical Endodontic Treatment. J Evid Based Dent Pract. 2021;21(2):101536.
https://doi.org/10.1016/j.jebdp.2021.101536
PMid:34391556

 

37. Elkhadem A, Ezzat K, Ramadan M, AbdelGhaffar S, Khamis D, Hassan A, et al. The effect of preoperative oral administration of prednisolone on postoperative pain in patients with symptomatic irreversible pulpitis: a single-centre randomized controlled trial. Int Endod J. 2018;51 Suppl 3:e189-e96.
https://doi.org/10.1111/iej.12795
PMid:28560802

 

38. Niazi SK. Placebo Effects: Neurological Mechanisms Inducing Physiological, Organic, and Belief Responses-A Prospective Analysis. Healthcare (Basel). 2024;12(22).
https://doi.org/10.3390/healthcare12222314
PMid:39595511 PMCid:PMC11593399

 

39. Zubieta JK, Bueller JA, Jackson LR, Scott DJ, Xu Y, Koeppe RA, et al. Placebo effects mediated by endogenous opioid activity on mu-opioid receptors. J Neurosci. 2005;25(34):7754-62.
https://doi.org/10.1523/JNEUROSCI.0439-05.2005
PMid:16120776 PMCid:PMC6725254

 

40. Nermo H, Petrenya N, Steingrímsdóttir Ó A, Stubhaug A, Nielsen CS, Hadler-Olsen E. Experimental pain tolerance is associated with dental anxiety- the Tromsø study 2015-2016. BMC Oral Health. 2025;25(1):1096.
https://doi.org/10.1186/s12903-025-06441-0
PMid:40615860 PMCid:PMC12231863