CarrascoLabra, AlonsoAlajlan, Norah2024-01-302024-01-302023-08-04https://hdl.handle.net/20.500.14154/71320Introduction: Endodontic treatment aims to alleviate pain associated with pulpal and periapical diseases by removing inflamed tissue and controlling infectious microbiological factors. Although endodontic treatment alone is highly effective in providing pain relief, it often does not provide immediate and complete relief. The potent anti-inflammatory effect of corticosteroids can produce an analgesic effect reducing inflammation. This study aimed to systematically search and review all available literature regarding systemic (orally administered or locally injected) corticosteroids in Endodontics to assess their effect on managing postoperative pain. Methods: A search was conducted using PubMed, Cochrane Library, Embase, Scopus, Dentistry & Oral Science, and ProQuest. In addition, the references of all primary studies and related systematic reviews were hand-searched for additional relevant primary studies. Randomized controlled trials enrolling participants undergoing endodontic treatment and assessing the presence of pain and pain scores at 6, 12, and 24 hours postoperatively were included. We synthesize the effect measures using risk ratios, standardized mean differences, and their corresponding 95% confidence intervals. Meta-analysis was performed using the random-effects inverse variance method. The level of significance was set at p < .05. The certainty of the evidence was evaluated using the GRADE approach. Results: A total of 2,303 participants in 29 trials were included in this meta-analysis. Patients who received corticosteroids were significantly less likely to report pain at 6 hours (RR = 2.5; 95% CI, 1.74 to 3.61; p < .00001), 12 hours (RR = 2.10; 95% CI, 1.53 to 2.90; p < .00001) and 24 hours (RR = 1.77; 95% CI, 1.38 to 2.28; p < .00001) postoperatively. They also reported lower pain intensity at 6 hours (SMD = - 0.82; 95% CI, -1.17 to -0.48; p < .00001), 12 hours (SMD = - 0.63; 95% CI, -0.75 to -0.51;p < .00001) and 24 hours (SMD = - 0.68; 95% CI, - 0.90 to -0.46; p < .00001) postoperatively. Conclusion: Moderate certainty evidence indicates that the use of systemic corticosteroids likely results in a large to moderate reduction in postoperative endodontic pain.57en-USCorticosteroidsendodonticspostoperative painsystematic review.Thesis