title: What is the Effect of No Endodontic Debridement on Postoperative Pain for Symptomatic Teeth with Pulpal Necrosis?
abstract: BACKGROUND
  Patients without a dentist or access to care may present to emergency rooms with pain. They are often prescribed medications until they can be treated. There are no studies to show if emergency endodontic debridement is better than giving medications during this symptomatic period. The purpose of this prospective, randomized study was to compare debridement versus no debridement on postoperative pain in emergency patients with symptomatic teeth, a pulpal diagnosis of necrosis, and a periapical radiolucency.
  
  
  METHODS
  Ninety-five patients presenting with moderate to severe pain were analyzed. The patients were randomly divided into 2 groups: group 1 received anesthesia and endodontic debridement, and group 2 received anesthesia but no debridement. At the end of the appointment, all patients were given ibuprofen/acetaminophen. If needed, they could receive an escape medication. Patients received a 5-day diary to record their pain levels and medication taken. Success was defined as no or mild postoperative pain and no use of escape medication. Success data were analyzed using a logistic regression.
  
  
  RESULTS
  Both groups had a decrease in postoperative pain and medication use over the 5 days. The debridement group had a significantly higher success rate than the no debridement group. There was no significant difference between the 2 groups with respect to escape drug use.
  
  
  CONCLUSIONS
  Patients receiving debridement or no debridement had a decrease in postoperative pain over the 5 days. Debridement resulted in a statistically higher success rate, but there was no significant difference in the need for escape medication.
authors.affiliation: Practice Limited to Endodontics, San Antonio, Texas.
authors.forename: Raquel
authors.initials: R
authors.lastname: Sebastian
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio. Electronic address: drum.13@osu.edu.
authors.forename: Melissa
authors.initials: M
authors.lastname: Drum
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio.
authors.forename: Al
authors.initials: A
authors.lastname: Reader
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio.
authors.forename: John
authors.initials: J
authors.lastname: Nusstein
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio.
authors.forename: Sara
authors.initials: S
authors.lastname: Fowler
authors.affiliation: Division of Biosciences, The Ohio State University, Columbus, Ohio.
authors.forename: Mike
authors.initials: M
authors.lastname: Beck
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003646:Debridement / Q000009:adverse effects / Q000379:methods*; D003790:Dental Pulp Necrosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods
chemical_list: D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D007052:Ibuprofen
keywords: Endodontic debridement; endodontic pain; pulpal necrosis; symptomatic endodontic patients