Emergency management of acute irreversible pulpitis with periapical injection of methylprednisolone

Objective: A periradicular injection of corticosteroid has been reported to have considerable efficacy in the emergency treatment of acute irreversible pulpitis. The aim of the present study was to examine these findings and to document the drug intake over a period of a week in patients receiving this treatment.
Methods: A total of 31 patients who presented with acute irreversible pulpitis pain at the dental clinics affiliated with the university teaching hospital in Dakar, Senegal underwent a periradicular injection with methylprednisolone acetate for emergency pain management. The patients were followed up at 1 week to evaluate the therapeutic outcome of their treatment and drug use.
Results: The treatment took approximately 8 minutes to perform. Immediately after the injection, 71% of the patients exhibited no spontaneous pain, and 87.1% had no pain on tooth percussion. On day 7, 77.4% of the patients were reassessed. The evaluation of the analgesic efficacy of the therapeutic procedure on the 24 available patients revealed a sum of pain intensity difference of 12.19 and a sum of pain percussion intensity difference of 0.77. The follow-up indicated that 58.3% required no pain medication on day 2 and 83.3% of patients used no pain medication on day 5. Ibuprofen was used by 37.5% of the patients on day 2 and by 4.2% on day 5. Paracetamol/codeine was used in 29.2% of the cases on day 1 and 4.2% of the cases on day 5.
Conclusion: The present study established that methylprednisolone injection for acute pulpitis is a feasible means to provide minimally invasive pharmacological relief and conserve dental resources.