Submucosal injection of dexamethasone or betamethasone for postoperative pain management in patients with symptomatic irreversible pulpitis: a randomized controlled clinical trial

Introduction: We evaluated the effect of apical submucosal infiltration of dexamethasone or betamethasone for postoperative pain management in symptomatic irreversible pulpitis. Methods:Ninety patients with symptomatic irreversible pulpitis in mandibular molars were randomly divided into three groups after single-visit endodontic treatment (n=30): control group (CG) received a sham injection, while dexamethasone (DG) and betamethasone (BG) groups received apical submucosal infiltration of 0.7 mL (4 mg/mL) dexamethasone or betamethasone. Patients rated pain intensity on a visual analog scale at 6, 12, 24, 48, and 72 hours after treatment. Patient sex and age were also evaluated. Results:Pain scores did not differ between men and women in any group orany time point. Age was correlated with pain in DG only at 72 hours, indicating that older participants had a lower perception of pain. At 6 and 12 hours, dexamethasone and betamethasone had similar effects on pain reduction, but at 24 hours, betamethasone was more effective. At 48 and 72 hours, DG and BG were both associated with significantly lower pain scores than CG, with no significant difference between the two steroids. Conclusion: Submucosal infiltration of dexamethasone or betamethasone reduced postoperative pain in patients with symptomatic irreversible pulpitis after single-visit endodontic treatment.