An updated meta-analysis on the efficacy and safety of medications administered after non-surgical root canal treatment in managing postoperative pain

Abstract

Effective management is one of the most important factors in mitigating postoperative endodontic pain (PEP). The purpose of this network meta-analysis was to compare the therapeutic effects and safety of different drugs commonly used for pain relief after non-surgical endodontic treatment. We searched the Scopus, PubMed, and Google Scholar databases until February 2024. Titles, abstracts, and full texts were identified according to predetermined criteria. Data were extracted from the selected publications, and a quality assessment was performed for the included studies. Sixteen RCTs with 2,021 participants were included in the meta-analysis. All included studies investigated the impact of NSAIDs on pain reduction in nonsurgical endodontic treatment. A statistically significant reduction in pain was observed at 8 h (pooled effect = -3.10, I(2) = 100), 12 h (pooled effect = -1.69, I(2) = 99.2), 24 h (pooled effect = -1.48, I(2) = 99.9), 48 h (pooled effect = -1.42, I(2) = 99.4), and 72 h (pooled effect = -0.64, I(2) = 73.1) of follow-up. The funnel plot was symmetrical, and sensitivity analysis excluded one article in 72 h follow-up. Overall, this meta-analysis demonstrated that NSAIDs and corticostreoids are statistically effective in relieving pain after non-surgical endodontic treatment. However, owing to the significant differences between studies and heterogenicity, additional randomized controlled trials are needed to validate this correlation further.