Endodontik Postoperatif Ağrı Yönetiminde Sistemik Kortikosteroidlerin Kullanımı
Özet
Postoperatif ağrı, periradiküler dokuların mikrobiyal irritasyonu ile ilgili iltihabi bir cevap olarak tanımlanmaktadır. Endodontik tedaviden birkaç saat veya gün sonrasında %3-57 oranında görülen bir komplikasyon olup hastaların tedavi sürecini ve hekime olan güvenini, operasyon sonrası konforu büyük ölçüde etkilemektedir. Tedavisinde sistemik veya kanal içi non-steroid/steroidal antienflamatuar ilaçlar, lazer/fotobiyomodülasyon tedavisi, uygun teknik/alet/materyal seçimi, oklüzal redüksiyon gibi bir dizi farmakolojik veya farmakolojik olmayan stratejinin klinisyenler tarafından kullanılması önerilmiştir. Kortikosteroidler, güçlü antienflamatuar özellikleri nedeniyle postoperatif ağrı yönetiminde tercih edilen ilaçlardan olmuştur. Kortikosteroidlerin doku hasarı bölgesindeki ağrıyı önleme potansiyeli, inflamatuar mediyatörlerin salınımının baskılanmasıyla sağlanmaktadır.
Postoperative pain is defined as an inflammatory response related to microbial irritation of periradicular tissues. It is a complication seen at a rate of 3-57% a few hours or days after endodontic treatment, and it greatly affects the treatment process of patients, their trust in the physician, and post-operative comfort. A number of pharmacological or non-pharmacological strategies have been recommended to be used by clinicians in its treatment, such as systemic or intracanal non-steroidal/steroidal anti-inflammatory drugs, laser/photobiomodulation therapy, appropriate technique/tool/material selection, and occlusal reduction. Corticosteroids have become the preferred drugs in postoperative pain management due to their strong anti-inflammatory effects. The potential of corticosteroids to prevent pain at the site of tissue damage is achieved by suppressing the release of inflammatory mediators.
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