The Outcome of Preoperative Administration of Single-dose Ketorolac, Non-steroidal Anti-inflammatory Drug and Placebo

NCT ID: NCT03116672

Last Updated: 2017-04-18

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 3 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2016-02-02
• Study Completion Date: 2017-02-10

Brief Summary

Aim. To compare the outcome of preoperative administration of single-dose ketorolac, non-steroidal anti-inflammatory drug and placebo on postoperative pain in teeth with irreversible pulpitis and apical periodontitis.

Detailed Description

The institutional review board of the Faculty od Odontology Tijuana México approved the study protocol and all the participants were treated in accordance with the Helsinki Declaration (www.cirp.org/library/ethics/helsinki). The study started in February 2016 and ended in February 2017. The main inclusion criteria were: a) A diagnosis of pulpitis confirmed by positive response to hot and cold tests and b) Clinical and radiographic evidence of symptomatic apical periodontitis. It was determined based on the clinical symptoms severe preoperative pain (VAS > 60) and severe percussion pain (VAS > 60). Confirmed by positive response to hot and cold tests. Thermal pulp testing was performed by the author, and radiographic interpretation was verified by one certified oral surgeon.

Patient selection.

Fifty-four of sixty-five patients (29 women and 25 men), 18 to 60 years of age with 54 eligible teeth consented to participate in the study. The study design is shown in Figure 1. The patients were randomly divided into three groups using a web program. The patient number and group number were recorded. Informed consent was obtained from each patient and the possible discomforts and risks were fully explained.

A total of 54 patients were divided into three groups (n = 18) according to the type of preoperative drug administrated, as follows: Group A: ketorolac 10mg (Siegfried Rhein S.A. de C.V, Mexico,DF), Group B: Diclofenac Na 50mg (Voltaren, Novartis Mexico), and Group C: A placebo (capsule filled with sugar).

A registered pharmacist compounded identical-appearing capsules of the ketorolac, Diclofenac Na and the placebo (opaque yellow size ''0'' capsules). All medications were placed in identical bottles so that they were indistinguishable to the investigator.

The administration of drugs and root canal treatment were performed by two different researchers. One assistant knew the allocation and the drug type in the capsules, but the operator and the patient did not know which drug type was administered.

Patient selection was based on the following criteria: 1) The aims and requirements of the study were freely accepted; 2) Treatment was limited to patients in good health; 3) Patients with symptomatic or asymptomatic teeth with vital pulps and apical periodontitis; 4) A positive response to hot and cold pulp sensitivity tests; 5) Presence of sufficient coronal tooth structure for rubber dam isolation; 6) No prior endodontic treatment on the involved tooth and 7) No analgesics or antibiotics were used five days before the clinical procedures began.

Exclusion criteria included the following: 1) Patients who did not meet inclusion requirements; 2) Patients who did not provide authorization for participation; 3) Patients who were younger than 16 years old; 4) Patients who were pregnant; 5) Patients who were diabetic; 6) Patients with a positive history of antibiotic use within the past month; 7) Patients whose tooth had been previously accessed or endodontically treated; 8) Teeth with root resorption, and 9) Immature/open apex, or a root canal in which patency of the apical foramen could not be established were all excluded from the study. Teeth with periodontal pockets deeper than 4 mm, or the presence of a periapical radiolucency more than 2 cm diameter also were excluded of the study.

Conditions

Pulpitis - Irreversible

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Placebo oral capsule

Administration of Placebo capsule 15 minutes before treatment

Group Type: EXPERIMENTAL

Placebo oral capsule

Intervention Type: DRUG

Administration of Placebo, 15 minutes before the clinical procedure.

ketorolac 10 mg

Administration of one dose Ketorolac 10 mg 15 minutes before treatment

Group Type: EXPERIMENTAL

one dose ketorolac 10 mg

Intervention Type: DRUG

Administration of ketorolac 10mg, (Dolac) 15 minutes before the clinical procedure.

Diclofenac

Administration of one dose Diclofenac 15 minutes before treatment

Group Type: EXPERIMENTAL

One dose Diclofenac

Intervention Type: DRUG

Administration of diclofenac, (Diclofenaco) 15 minutes before the clinical procedure.

Interventions

one dose ketorolac 10 mg

Administration of ketorolac 10mg, (Dolac) 15 minutes before the clinical procedure.

Intervention Type: DRUG

One dose Diclofenac

Administration of diclofenac, (Diclofenaco) 15 minutes before the clinical procedure.

Intervention Type: DRUG

Placebo oral capsule

Administration of Placebo, 15 minutes before the clinical procedure.

Intervention Type: DRUG

Other Intervention Names

Dolac; Diclofenaco; Placebo OS

Eligibility Criteria

Inclusion Criteria

Patient selection was based on the following criteria:

1. The aims and requirements of the study were freely accepted;

2. Treatment was limited to patients in good health;

3. Patients with symptomatic or asymptomatic teeth with vital pulps and apical periodontitis;

4. A positive response to hot and cold pulp sensitivity tests;

5. Presence of sufficient coronal tooth structure for rubber dam isolation;

6. No prior endodontic treatment on the involved tooth and

7. No analgesics or antibiotics were used five days before the clinical procedures began.

Exclusion Criteria

1. Patients who did not meet inclusion requirements;

2. Patients who did not provide authorization for participation;

3. Patients who were younger than 16 years old;

4. Patients who were pregnant;

5. Patients who were diabetic;

6. Patients with a positive history of antibiotic use within the past month;

7. Patients whose tooth had been previously accessed or endodontically treated;

8. Teeth with root resorption, and

9. Immature/open apex, or a root canal in which patency of the apical foramen could not be established were all excluded from the study. Teeth with periodontal pockets deeper than 4 mm, or the presence of a periapical radiolucency more than 2 cm diameter also were excluded of the study.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Universidad Autonoma de Baja California

OTHER

Sponsor Role: lead

Responsible Party

Jorge Paredes Vieyra

Principal Investigator. PhD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Miguel O Osuna, DDS

Role: STUDY_DIRECTOR

SECRETARIA DE SALUD DE BC

Locations

Jose Clemente

Tijuana, Estado de Baja California, Mexico

Countries

Mexico

References

Paredes-Vieyra J, Enriquez FJ. Success rate of single- versus two-visit root canal treatment of teeth with apical periodontitis: a randomized controlled trial. J Endod. 2012 Sep;38(9):1164-9. doi: 10.1016/j.joen.2012.05.021. Epub 2012 Jul 26.

Reference Type: RESULT

PMID: 22892729 (View on PubMed)

Study Documents

Document Type: Clinical Study Report

Clinical trial that evaluate drug and placebo

View Document

Document Type: Individual Participant Data Set

Clinical Guide

View Document

Other Identifiers

One Dose 2017

Identifier Type: -

Identifier Source: org_study_id