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Conclusion 10. Isett J, Reader A, Gallatin E, Beck M, 23. IdrisM. Intraosseous injection as an adjunct
Patients with emergency conditions like Padgett D. Effect of an intraosseous injection of to conventional local anesthetic techniques: A
acute irreversible pulpitis, where analge- depo-medrol on pulpal concentrations of PGE2 clinical study, Journal of Conservative Dentistry
sics may not alleviate pain, can be managed and IL-8 in untreated irreversible pulpitis; J En- (JCD), 2014.
temporarily by using methyl prednisolone dod. 2003 Apr;29(4):268-7. 24. Iranmanesh F, Masoud Parirokh, Ali Akbar
acetate (Depo-Medrol) until endodon- 11. Nusstein J, Reader A, Nist R, Beck M, Mey- Haghdoost. Effect of Corticosteroids on Pain Re-
tic management is initiated. In situations ers WJ. Anesthetic efficacy of the supplemen- lief Following Root Canal Treatment: A System-
where attaining complete anesthesia is not tal intraosseous injection of 2% lidocaine with atic Review; Iran Endod J. 2017 Spring; 12(2):
possible due to the inflammatory condition 1:100,000 epinephrine in irreversible pulpitis; J 123–130.
of the pulp, lack of time, coronal or root Endod. 1998 Jul;24(7):487-91. 25. Olivia Kérourédan, 1,2,3 Léonard Jallon, Paul
1,3
anatomy which makes pulpal debridement 12. Keenan JV , Farman AG, Fedorowicz Perez, Christine Germain, Jean-François Péli.
5
1
5
impossible, calcified canals or extreme Z, Newton JT. Antibiotic use for irreversible Efficacy of orally administered prednisolone
painful conditions due to unknown reason pulpitis; Cochrane Database Syst Rev. 2005 Apr versus partial endodontic treatment on pain
where complete pulpectomy cannot be at- 18;(2). reduction in emergency care of acute irreversible
tained on emergency visit, an intraosseous 13. Fouad A.F. Are antibiotics effective for end- pulpitis of mandibular molars: study protocol for a
injection of methyl prednisolone acetate odontic pain? Endodontic Topics. randomized controlled trial; Trials. 2017; 18: 141.
(Depo-Medrol) can alleviate pain to a man- 26. Parente Stephen,Anderson RW, Herman WW,
ageable level until endodontic treatment can 14. Aggarwal V, Singla M, Miglani S, Ansa- Kimbrough WF, Weller RN. Anesthetic efficacy
ri I, Kohli S. A prospective, randomized, sin-
be performed with ease and comfort. gle-blind comparative evaluation of anesthetic of the supplemental intraosseous injection for
efficacy of posterior superior alveolar nerve teeth with irreversible pulpitis;. J Endod. 1998
Further studies need to be conducted on blocks, buccal infiltrations, and buccal plus pala- Dec;24(12):826-8.
the effect of various glucocorticoids, on tal infiltrations in patients with irreversible pulpi-
their dosage, route of administration and on tis; J Endod. 2011 Nov;37(11):1491-4. Indu Cheragapadath
their ability to alleviate pain associated with 1 2 3 Radhakrishnan received
acute irreversible pulpitis and periapical 15. Bane K , Charpentier E , Bronnec F , De- her B.D.S from Century
scroix V , Gaye-N’diaye F , Kane AW , Toledo
1
3
1
periodontitis. R , Machtou P , Azérad J . Randomized Clin- International Institute of
3
3
4
ical Trial of Intraosseous Methylprednisolone Dental Science and Re-
References Injection for Acute Pulpitis Pain. J Endod. 2016 search Centre in 2009.
1. Lin Kimmy. Local Anaesthesia in the Manage- Jan;42. Indu persued her Masters
ment of Painful Pulpitis; New Zealand 17. in Conservative Dentistry
16. Coggins R, Reader A, Nist R, Beck M, Mey- and Endodontics from
2. Gallatin E, Reader A, Nist R, Beck M. Pain ers WJ. Anesthetic efficacy of the intraosseous Ragas Dental College and Hospital.
reduction in untreated irreversible pulpitis using injection in maxillary and mandibular teeth;Oral
an intraosseous injection of Depo-Medrol. J En- Surg Oral Med Oral Pathol Oral RadiolEn- Dr. C.S. Karumaran is a
dod. 2000 Nov;26(11):633-8.Endodontic Jour- dod. 1996 Jun; 81(6):634-41. professor in the Depart-
nal April 2010, 41, 5-16. ment of Conservative
3. Kérourédan O, Jallon L, Perez P, Germain 17. Chance K, Louis Lin, Francis ES. Clinical Dentistry and Endodon-
trial of intracanal corticosteroid in root canal
C, Péli JF , Oriez D. Efficacy of orally admin- therapy; J Endod. 1987 Volume 13, Issue 9, tics at the Ragas Dental
1,3
istered prednisolone versus partial endodontic Pages 466–468. College and Hospital in
treatment on pain reduction in emergency care of Chennai, India. He earned

acute irreversible pulpitis of mandibular molars: 18. Dan-Krister Rechenberg, Ulrike Held, Jakob his undergraduate and post
study protocol for a randomized controlled trial, M. Burgstaller, Gabriel Bosch. Pain levels and graduate degrees from the
rials. 2017 Mar 28;18(1):14. typical symptoms of acute endodontic infections: same dental school. He has 15 publications to
a prospective, observational study; BMC Oral his credit. His fields of interest include micro-
4. Marshal J Gordon, Walton R. The effect of in- Health. 2016; 16: 61. surgery, regenerative endodontic procedures,
tramuscular injection of steroid on post treatment and pain management.
endodontic pain; J Endod. 1984 Dec;10(12):584-8. 19. Douglas nagle,Reader A, Beck M, Weav-
er J. Oral Pathology, Oral Radiology and End- Dr. Anil Kumar
5. Moore PA, Hersh EV. Local anesthetics: odontics, Oral Surg Oral Med Oral Pathol Oral
pharmacology and toxicity; Dent Clin North RadiolEndod. Effect of systemic penicillin on Ramachandran is currently,
Am. 2010 Oct;54(4):587-99. pain in untreated irreversible pulpitis, 2000 the Professor and Head
of the Department of Con-
6. Gallatin Juliane, Reader Al, Nusstein John, Nov90(5):636-40. servative Dentistry and Endo-
Beck Mike, Weaver Joel. A comparison of two 20. Dunbar D , Reader A, Nist R, Beck dontics in Ragas Dental
1
intraosseous anesthetic techniques in mandib- M, Meyers WJ. Anesthetic efficacy of the College,Tamil Nadu, India.
ular posterior teeth JADA, November 2003; intraosseous injection after an inferior alveolar He has undergone
134;1476-1484. nerve block; J Endod. 1996 Sep;22(9):481-6. training in the University of Hong Kong
7.Bramy .E, A. Reader, E. Gallatin, R. Nist, M. 21. Fedorowic Z,vanZuuren EJ,Farman AG, Ag- in Advanced Microsurgical Endodontics
and also has a Certificate in Implantology
Beck, J. Weave. Pain reduction in symptomatic, nihotry A,Al-Langawi JH. The Cochrane Data- from the Manipal Academy of Higher
necrotic teeth using an intraosseous injection of base of Systematic reviews, Antibiotic use for Education(MAHE).
Depo-Medrolr, J Endond,April 1999. irreversible pulpitis, 2013. Dr. Anil is very passionate about
8. Marshal.J Gordon. Consideration of ste- 22. Gallatin J, Nusstein J, Reader A, Beck M, Surgical Endodontics (which is his favorite
roids for endodontic pain; Endodontic Topics Weaver A. Comparison of injection pain and area of expertise) and research. He has
2002,3,41-45. postoperative pain of two intraosseous anesthetic many publications in various national and
9. Thangavel Boopathi, Mathew Sebeena, Kaila- techniques,; J.Anesthesia ProgressAnesthProg. international journals to his credit and also
has several studies pending patents.
sam Sivakumar, Jayakodi Harikaran. Supple- 2003.
mental pulpal anesthesia for mandibular teeth;
J Pharm Bioallied Sci. 2013 Jun; 5(Suppl 1):
S103–S108.
www.nysagd.org l Spring 2020 l GP 20