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Effect of Vitamin D on Postoperative Pain in Symptomatic Irreversible Pulpitis

2026년 5월 5일 업데이트: Shady Mamdouh Elsayed Elsayed Badawy, Future University in Egypt

The Effect of Vitamin D Supplementation Protocol on Post Operative Pain in Patients With Symptomatic Irreversible Pulpitis of Mandibular First Molar Teeth After Root Canal Treatment. "A Triple Blinded Clinical Randomized Control Trial"

Vitamin D deficiency (VDD) is a prevalent global health concern that has been linked to altered pain perception through its effects on inflammatory pathways, nociceptor activity, and neurotrophic signaling. While its role in chronic pain has been widely studied, limited evidence exists regarding its impact on acute postoperative dental pain. This triple-blinded randomized controlled clinical trial aims to evaluate the effect of moderate-dose vitamin D supplementation on postoperative pain following single-visit root canal treatment (RCT) in patients with symptomatic irreversible pulpitis affecting mandibular first molars. A total of 54 vitamin D-deficient patients (serum 25(OH)D <30 nmol/L), aged 20-45 years, will be randomly allocated into three groups: a single preoperative dose group (150,000 IU vitamin D₃), a fractionated dose group (50,000 IU over three consecutive days), and a placebo group. All participants will undergo standardized single-visit RCT procedures. Postoperative pain will be assessed using a Modified Visual Analog Scale (VAS) at baseline and at 6, 12, 24, and 48 hours post-treatment, while analgesic intake will be recorded as a secondary outcome. It is hypothesized that vitamin D supplementation will significantly reduce postoperative pain levels and analgesic consumption compared to placebo. This study seeks to explore vitamin D as a safe, cost-effective adjunct in endodontic pain management, with potential implications for improving clinical outcomes in patients with VDD undergoing RCT.

연구 개요

상세 설명

This study is a triple-blinded randomized controlled clinical trial designed to evaluate the effect of vitamin D supplementation on postoperative pain following single-visit root canal treatment (RCT) in patients with symptomatic irreversible pulpitis affecting mandibular first molars.

Vitamin D deficiency (VDD) is highly prevalent worldwide and has been increasingly linked to pain modulation mechanisms, including effects on nociceptors, inflammatory pathways, neurotrophic factors, and immune responses. Despite evidence supporting its role in chronic pain, limited research has investigated its effect on acute dental pain, particularly postoperative endodontic pain.

Aim

To assess whether moderate-dose vitamin D supplementation reduces postoperative pain levels in vitamin D-deficient patients undergoing RCT.

Study Design & Participants Sample size: 54 patients (18 per group)

Population: Adults (20-45 years) with:

Vitamin D deficiency (<30 nmol/L) Symptomatic irreversible pulpitis in mandibular first molars All treatments are performed in a single visit under standardized clinical conditions.

Intervention Groups Group A: Single high dose (150,000 IU vitamin D₃) preoperatively Group B: Fractionated dose (50,000 IU for 3 days: pre-op + 2 days post-op) Group C: Placebo

Vitamin D is administered with dietary fat to enhance absorption.

Outcome Measures

Primary outcome:

Postoperative pain assessed using Modified Visual Analog Scale (VAS) at:

Preoperative baseline 6, 12, 24, and 48 hours post-treatment

Secondary outcome:

Analgesic intake (number of patients and tablets consumed) Methodology Highlights

Standardized RCT protocol including:

Rubber dam isolation Rotary instrumentation (crown-down technique) Sodium hypochlorite irrigation (5.25%) Continuous wave obturation Only ibuprofen (600 mg) allowed as rescue analgesic Strict triple blinding (patient, operator, assessor) to eliminate bias Hypothesis Null hypothesis: No difference in postoperative pain between vitamin D and placebo groups.

Significance

This study addresses a gap in endodontic pain management, exploring vitamin D as a potential adjunctive, low-cost, and biologically plausible analgesic strategy. If effective, it may influence clinical protocols for managing acute pulpitis-related pain and postoperative discomfort.

연구 유형

중재적

등록 (실제)

54

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Select A State Or Province
      • New Cairo, Select A State Or Province, 이집트
        • Future University in Egypt

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인

건강한 자원 봉사자를 받아들입니다

아니

설명

Inclusion Criteria:

  • Patients with serum 25-hydroxyvitamin D level below 30 nmol/L with no vitamin D supplementation for the preceding 3 months.
  • Patients diagnosed with symptomatic irreversible pulpitis.
  • Mandibular first molar:

Classification of root canal configuration according to Weine's classification:

  • Distal root: with one portal of exit
  • Mesial root: Type III, two separate and distinct canals extend from the pulp chamber to the apex.

    • Patients with moderate to severe pre-operative pain with pain score from 6-10.
    • Medically free patients with no systemic disease: (American Society of Anesthesiologists / (ASA Class I or II).
    • The age range is between 20 to 45 years.
    • Patients have restorable mandibular permanent molars that were diagnosed with symptomatic irreversible pulpitis.
    • Positive patient's acceptance for participating in the study and signing informed consent

Exclusion Criteria:

  • Patients that have been taking vitamin D supplements in the last 3 months.
  • Patients with serum 25-hydroxyvitamin D level above 30 nmol/L.
  • Patients diagnosed with necrosis, partial necrosis, acute or chronic abscess.
  • Presence of periapical radiolucency.
  • Patients with systemic conditions that may affect pain perception (e.g., fibromyalgia, diabetes, chronic pain disorders).
  • Pregnant or lactating females.
  • Psychologically disturbed patients.
  • Patients with a history of allergy to any medication used in the study are excluded.
  • Patients with mild to moderate pain with pain scores less than 6.
  • Teeth that have:

    • Periodontally affected molars with grade 2 or 3 mobility.
    • Non-restorable teeth.
    • Abnormal anatomy and calcified canals.
    • Previous root canal treatment.
  • Patients above 45 years old or below 20 years old.
  • Non-compliant patients to follow ups.
  • Patients with very poor oral hygiene.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 지지 요법
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 삼루타

무기와 개입

참가자 그룹 / 팔
개입 / 치료
활성 비교기: Single dose 150000 IU Vitamin D3
Preoperative supplementation of 150000 IU Vitamin D3 soft gel oral capsules with dietary fat prior to single visit root canal treatment in mandibular first molar with symptomatic irreversible pulpitis
Preoperative supplementation of 150000 IU Vitamin D3 soft gel oral capsules with dietary fat prior to single visit root canal treatment in mandibular first molar with symptomatic irreversible pulpitis
50000 IU preoperative Vit D3 oral soft gel capsule with dietary fat prior to root canal treatment in mandibular first molars with symptomatic irreversible pulpitis followed by 50000 IU on the second day and 50000 IU on the third day.
활성 비교기: 150000 IU Vitamin D3 on 3 consecutive days 50000 IU each.
50000 IU preoperative Vit D3 oral soft gel capsule with dietary fat prior to root canal treatment in mandibular first molars with symptomatic irreversible pulpitis followed by 50000 IU on the second day and 50000 IU on the third day.
Preoperative supplementation of 150000 IU Vitamin D3 soft gel oral capsules with dietary fat prior to single visit root canal treatment in mandibular first molar with symptomatic irreversible pulpitis
50000 IU preoperative Vit D3 oral soft gel capsule with dietary fat prior to root canal treatment in mandibular first molars with symptomatic irreversible pulpitis followed by 50000 IU on the second day and 50000 IU on the third day.
위약 비교기: Placebo Comparator
Matched soft Gel capsules to Vit D3 capsules, 3 oral soft gel capsules preoperative to single visit root canal treatment in mandibular first molars with symptomatic irreversible pulpitis
Matched soft Gel capsules to Vit D3 capsules, 3 oral soft gel capsules preoperative to single visit root canal treatment in mandibular first molars with symptomatic irreversible pulpitis

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Postoperative Pain
기간: Preoperative and on the 6th, 12th, 24th, 48th hours postoperative
A form will be given to patients to be filled in with respect to post-operative pain: preoperative and on the 6th, 12th, 24th, 48th hour postoperative. The presence of post-operative pain is accessed by visual analog scale (VAS) scale (0-10), where 0 showed no pain, 1-3 mild pain, 4-6 moderate pain, 7-9 severe pain, and 10 worst possible pain.
Preoperative and on the 6th, 12th, 24th, 48th hours postoperative

2차 결과 측정

결과 측정
측정값 설명
기간
Number of analgesic intake
기간: 6th,12th,24th and 48th hours postoperative
Patients were advised to take oral ibuprofen 600 mg only in cases of severe or persistent pain and were asked to follow up intervals of 6,12,24 and 48 hours postoperative about the number of taken analgesic pills if any
6th,12th,24th and 48th hours postoperative

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 연구 책임자: Hesham Mohamed Salah, PHD in Endodontics, Future University in Egypt

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2025년 11월 1일

기본 완료 (실제)

2026년 5월 1일

연구 완료 (추정된)

2026년 8월 1일

연구 등록 날짜

최초 제출

2026년 5월 5일

QC 기준을 충족하는 최초 제출

2026년 5월 5일

처음 게시됨 (실제)

2026년 5월 12일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 5월 12일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 5월 5일

마지막으로 확인됨

2026년 5월 1일

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