Systemic and local applications of steroids in endodontics: an update review

Up to 80% of endodontic patients who report with preoperative pain continue to experience some level of pain following the endodontic procedure. Various classes of drugs have been studied for the management of post-treatment endodontic pain. Since endodontic pain is often associated with chronic inflammation, the presence of bacterial by-products, influx of primed immune cells and activation of the cytokine network and other inflammatory mediators, pain may be reduced by administration of glucocorticoid steroids. The aim of this paper is to review the pharmacology and mechanisms of actions of steroids as well as their indications for endodontics, contraindications, dosages and side-effects.