***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction : The present clinical trial aim ed to evaluate and compare the effect of a single pretreatment dose of ketorolac ( 20 mg ) , prednisolone ( 30 mg ) , and placebo on postendodontic pain in patients undergoing endodontic therapy for irreversible pulpitis or pulpal necrosis using a visual analog scale . Methods : Ninety‐two subjects were included in the present trial ; 46 subjects had a pulpal diagnosis of irreversible pulpitis , and the other 46 had pulpal necrosis . These subjects were r and omly allocated into 1 of the 3 pretreatment medication groups : ketorolac ( 20 mg ) , prednisolone ( 30 mg ) , or a placebo . The drugs were administered 30 minutes before the procedure followed by a routine single‐visit root canal treatment . Preoperative and postoperative pain was evaluated using a visual analog scale at 6 time intervals . A comparison between the different groups was performed using one‐way analysis of variance followed by the Tukey post hoc test . A comparison of pain within each group at various time intervals was performed using repeated measures analysis of variance followed by the paired t test and Bonferroni correction . Results : At the end of 6 hours , in irreversible pulpitis cases , the ketorolac group showed an effective reduction in pain scores compared with the other drugs . At the end of 12 hours , the prednisolone group significantly reduced the pain scores compared with the other drugs . Conclusions : From this study , it could be concluded that a single pretreatment dose of prednisolone has a more sustained effect in reducing postendodontic pain compared with placebo or ketorolac Aim : Study aim ed to evaluate the efficacy of two different pretreatment single oral doses of betamethasone on the incidence of inter-appointment flare up and postoperative discomfort . Material s and Methods : Fifty-four patients aged 18–59 years requiring endodontic treatment were selected and r and omly assigned to three groups ; single pretreatment oral dose of placebo or betamethasone in two different oral doses of 0.5 mg and 1 mg , respectively . Endodontic therapy was completed in two visits using triple antibiotic paste as intracanal medicament . Patients were given a question naire to record their pain at 1 , 2 , 3 , and 7 days after treatment . In the second visit , obturation was done , and the patients were again instructed to record their pain scores after treatment and discharged . The verbal rating scale was used for recording the pain scores . Statistical analysis was done using ANOVA and the Friedman test . Results : 0.5 mg betamethasone group showed least mean pain scores among all experimental groups ; however , there was no statistically significant difference between any of the groups ( P > 0.05 ) . Conclusion : Pretreatment single oral dose of betamethasone is an effective in managing endodontic flare-ups ; however , the results were statistically insignificant Introduction : One of the aims of root canal treatment is to prevent or eliminate pain . Postoperative endodontic pain control continues to be a significant challenge . Aim : To compare and evaluate the effect of single oral dose of 100 mg of tapentadol , 400 mg of etodolac , or 10 mg of ketorolac as a pretreatment analgesic for the prevention and control of postoperative endodontic pain in patients with symptomatic irreversible pulpitis . The incidence of side effects was recorded as secondary outcome . Material s and Methods : Sixty emergency patients with moderate to severe pain , diagnosed with symptomatic irreversible pulpitis were r and omly allocated ( 1:1:1 ) to any of the three groups ; tapentadol , etodolac , or ketorolac . Medications were administered 30 min before beginning of the endodontic treatment . Patients recorded pain intensity on 10 cm visual analog scale ( VAS ) after treatment , for upto 24 h. Results : At 24 h , mean ±st and ard deviation ( SD ) of VAS scores ( in cm ) for tapentadol , etodolac , and ketorolac were 0.89 ± 0.83 , 2.68 ± 2.29 , and 0.42 ± 0.69 , respectively . Kruskal-Wallis ( K-W ) test showed significant difference among the three groups ( P = 0.001 ) . Mann-Whitney test showed significantly lower VAS scores in tapentadol and ketorolac than etodolac group ( P = 0.013 and 0.001 , respectively ) . Conclusions : Single oral dose of 10 mg of ketorolac and 100 mg of tapentadol as a pretreatment analgesic significantly reduced postoperative endodontic pain in patients with symptomatic irreversible pulpitis when compared to 400 mg of etodolac One hundred six patients with pretreatment pain presenting for endodontic treatment participated in a controlled double-blind study of dexamethasone use . Endodontic therapy was performed and , after controlling for use of nonuse of dexamethasone , patient variables and treatment factors were evaluated for their effects on endodontic posttreatment pain .  Patients with no radiographic periapical lesions had significantly more pain than patients with periapical lesions at 8- , 24- , 48- , and 72-h posttreatment regardless of whether they received placebo or dexamethasone . No other patient or treatment factors correlated with posttreatment pain . Twenty-two patients in the subgroup receiving placebo reported an 81 % incidence of posttreatment pain , 73 % of them required posttreatment pain medications . By 72-h posttreatment , the incidence and severity of pain in the placebo group was minimal Introduction : The aim of this r and omized-controlled clinical trial was to assess the effect of intraligamentary ( PDL ) injection of dexamethasone on onset and severity of post-treatment pain in patients with symptomatic irreversible pulpitis . Methods and Material s : A total number of 60 volunteers were included according to the inclusion criteria and were assigned to three groups ( n=20 ) . After administration of local anesthesia and before treatment , group 1 ( control ) PDL injection was done with syringe containing empty cartridge , while in groups 2 and 3 the PDL injection was done with 0.2 mL of 2 % lidocaine or dexamethasone ( 8 mg/2 mL ) , respectively . Immediately after endodontic treatment patients were requested to mark their level of pain on a visual analogue scale ( VAS ) during the next 48 h ( on 6 , 12 , 24 and 48-h intervals ) . They were also asked to mention whether analgesics were taken and its dosage . Considering the 0 - 170 markings on the VAS ruler , the level of pain was scored as follows : score 0 ( mild pain ; 0 - 56 ) , score 1 ( moderate pain ; 57 - 113 ) and score 3 ( severe pain ; 114 - 170 ) . The data were analyzed using the Kruskal-Wallis and the Chi-square tests and the level of significance was set at 0.05 . Results : After 6 and 12 h , group 1 and group 3 had the highest and lowest pain values , respectively ( P<0.01 and P<0.001 for 6 and 12 h , respectively ) . However , after 24 and 48 h the difference in the pain was not significant between groups 1 and 2 ( P<0.6 ) but group 3 had lower pain levels ( P<0.01 and P<0.8 for 24 and 48 h , respectively ) . Conclusion : Pretreatment PDL injection of dexamethasone can significantly reduce the post-treatment endodontic pain in patients with symptomatic irreversible pulpitis A clinical study using non-vital maxillary central incisors exhibiting acute apical periodontitis was carried out to evaluate the incidence of post-operative pain after biomechanical preparation and dressing with a calcium-hydroxide paste or a corticosteroid-antibiotic solution .  Sixty teeth from 48 patients were prepared and dressed on the first visit and re-evaluated clinical ly 7 days later . No difference was observed in the incidence of post-operative pain between the two groups The root canals of 588 consecutive nonsurgical patients with varying levels of pain were completely instrumented in 10 endodontic practice s and 4 endodontic graduate programs . The participants were sequentially assigned to one of nine medications and a placebo . The severity of pain was assessed by the visual analog scale for 72 h following instrumentation . Among all of the parameters studied , three factors ( preoperative pain , apprehension , and types of medication ) were found to be significant in determining postinstrumentation pain . An association was found between the intensity of pre- and postoperative pain . As the intensity of preoperative pain increased , the chances for more severe postoperative pain increased ( p < 0.0001 ) . In addition , an association between the presence of apprehension before any treatment and postoperative pain was also noted ( between 0.012 < p < 0.047 ) . Examination of the time-effect curves for various medications in patients with no mild pain showed no statistical significant difference between the effectiveness of different medications and placebo . However , a multiple comparison of the effectiveness of various medications and placebo on patients in moderate and severe preoperative pain showed that  ibuprofen , ketoprofen , erythromycin base , penicillin , and methylprednisolone plus penicillin  were more effective than placebo within the first 48 h following complete instrumentation INTRODUCTION The present study reports the results of a r and omized clinical trial comparing local intraosseous methylprednisolone injection and emergency pulpotomy in the management of acute pulpitis on efficacy , safety , and efficiency end points . METHODS After providing prior informed written consent , 94 patients consulting for acute irreversible pulpitis pain at university-affiliated teaching hospital dental clinics in Dakar , Senegal were r and omly assigned to either the methylprednisolone treatment group ( n = 47 ) or the pulpotomy treatment group ( n = 47 ) . Patients were followed up at 1 week and assessed 6 months later to evaluate the therapeutic outcome of their treatment . RESULTS At day 7 the patients in the methylprednisolone group reported less intense spontaneous and percussion pain in the day 0-day 7 period than the patients in the pulpotomy group . Methylprednisolone treatment took approximately 7 minutes ( 4.6 - 9.3 ) less to accomplish than pulpotomy ( or about half the time ) . No difference in the therapeutic outcome was found between the 2 treatment groups at 6 months ( all credible intervals span 0 ) . CONCLUSIONS This study establishes that methylprednisolone injection for acute pulpitis is relieved by a minimally invasive pharmacologic approach more effectively than by the reference pulpotomy and conserves scarce dental re sources ( ie , endodontic equipment and supplies , dental surgeon 's time ) To determine whether a relatively large dose of oral dexamethasone given for a short period of time would be effective in reducing endodontic interappointment pain , the current double-blind , placebo-controlled study was undertaken . After the visit for instrumentation , 40 patients with asymptomatic teeth having vital-inflamed pulps were r and omly given either dexamethasone ( 3 tablets of 4 mg each ) or a dextrose placebo identical in appearance ( same dosage schedule ) . The outcome showed that the oral administration of dexamethasone result ed in a statistically significant reduction in endodontic interappointment pain at all three time periods evaluated , that is , at 8 hours , 24 hours , and 48 hours ( p less than 0.01 ) . It appears from the results of this study that this dosage schedule of oral dexamethasone is sufficient to significantly reduce endodontic interappointment pain for teeth with asymptomatic vital-inflamed pulps . Further studies are needed for teeth with other endodontic pulpal-periapical conditions and for symptomatic teeth OBJECTIVE The purpose of this r and omized , double-blind study was to determine the effect of a corticosteroid-antibiotic combination when used as an intracanal medicament for the treatment of posttreatment pain in endodontically involved teeth with vital pulp-test readings . STUDY DESIGN Out of 988 patients , 480 experienced intratreatment pain . Endodontic treatment was completed in 3 visits . Patients who experienced pain after the first or second visit ( postextirpation or postinstrumentation ) were given an emergency visit during which no local anesthetic was used . The patients r and omly received either intracanal corticosteroid-antibiotic compound or a placebo . Patients subjectively rated their pain on a scale of 1 to 4 as none , mild , moderate , and severe . The ratings were done at 1 , 2 , 4 , 8 , 12 , and 24 hours postmedication . RESULTS Intracanal use of the corticosteroid-antibiotic medication significantly reduced ( P < .001 ) the mean pain score quite rapidly and was significantly superior to the placebo until the end of the study ( P < .001 ) . Furthermore , there were no reoccurrences of pain , and no side effects from use of the drug were noted . CONCLUSION These results support the intracanal use of corticosteroid-antibiotic combination for controlling posttreatment endodontic pain OBJECTIVE The purpose of this prospect i ve study was to analyze the effect of etodolac versus dexamethasone in reducing postoperative pain in patients who had surgical endodontic treatment using a 
    Output:
    
Conclusions : Corticosteroids had a postoperative pain‐reducing effect in endodontic patients , and the choice of drug regimens could be an important predictor of pain reduction .
Obtained results from 18 r and omized clinical trials showed corticosteroids significantly reduced the incidence of postoperative pain in endodontic patients at 6 , 12 , and 24 hours .
There was a significant difference among drugs , and prednisolone was the best choice in this regard