Local Dexamethasone Administration in Symptomatic Irreversible Pulpitis

Recruiting now · Not applicable

Conditions studied: Symptomatic Irreversible Pulpitis (SIP), Dental Pain

In brief

Symptomatic irreversible pulpitis is associated with a high incidence of inadequate pulpal anesthesia during endodontic treatment, particularly in mandibular molar teeth. Failure to achieve profound anesthesia may result in increased intraoperative pain and patient discomfort. Corticosteroids have been suggested as adjunctive agents to improve pain control and reduce inflammatory responses; however, the influence of different local administration techniques on anesthetic success and postoperative pain remains unclear. The aim of this randomized controlled clinical trial is to compare the effects of submucosal and intraligamentary dexamethasone administration on anesthetic success and pain control in patients with symptomatic irreversible pulpitis. A total of 84 participants requiring root canal treatment of mandibular first or second molars diagnosed with symptomatic irreversible pulpitis will be randomly allocated to one of three groups: (1) inferior alveolar nerve block (IANB) followed by submucosal saline injection (control group), (2) IANB followed by submucosal dexamethasone injection, and (3) IANB followed by intraligamentary dexamethasone injection. All participants will receive standardized endodontic treatment under local anesthesia. The primary outcome measure is anesthetic success during access cavity preparation and pulp extirpation. Secondary outcome measures include postoperative pain intensity at 6, 12, 24, 48, and 72 hours, and postoperative analgesic consumption. The results of this study may provide evidence regarding the effectiveness of different local dexamethasone administration techniques and contribute to improved pain management strategies in endodontic practice.

Key facts

Study ID

NCT07672873

Run by

Marmara University

People needed

84

Starts

2026-06-15

Expected to finish

2026-12-18

Last updated by the study team

2026-06-29

Who can join

Age: 18 and older, up to 65. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Patients aged 18 to 65 years.
• ASA I or ASA II systemic health status.
• Symptomatic irreversible pulpitis in a mandibular molar tooth.
• Positive response to pulp sensibility tests.
• Preoperative pain score greater than 54 mm on the Heft-Parker Visual Analog Scale (HP-VAS).
• Ability to understand the study procedures and provide written informed consent.

You may not qualify if…

• Pregnancy or lactation.
• Allergy or contraindication to articaine, dexamethasone, or study-related medications.
• Use of analgesics, anti-inflammatory drugs, or antibiotics within the previous 12 hours.
• Presence of periapical radiolucency or diagnosis of pulpal necrosis.
• Significant systemic disease (ASA III or higher).
• Inability to complete pain assessment forms or follow study procedures.

Where it is running

• Marmara University Faculty of Dentistry — Istanbul, Turkey (Türkiye) (enrolling)

Full record on ClinicalTrials.gov

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