A comparison of Pharmaceutical regiments following first stage root canal treatment

Abstract

AIM: The purpose of this clinical trial was to investigate the analgesic efficacy of four oral medication groups on postoperative endodontic pain after first stage root canal treatment. The four groups will be Methodology: Patients presenting to the University of Minnesota emergency graduate endodontic clinic experiencing pain greater than or equal to 3/10 were considered potential condidiates. 22 patients were included based on an established inclusion criteria. Following administration of local anaestheisa, a pulpectomy was performed. The patients were administered the following at 4 hour time intervals: (1) 2 doses of Placebo; (2) 2 800mg doses of Ibuprofen; (3) 2 800mg Ibuprofen with Vicodin 325/7.5mg; (4) 1 dose of 550mg Anaprox DS (Naproxen) and 1 dose of Placebo. Patients recorded pain intensity following treatment on a visual analogue scale, Heft parker scale and a baseline four-point category pain scale before and immediately after treatment, then one hour after the initial dose of medication, and one hour after the second dose of medication. The following day, pain was recorded at breakfast, lunch, dinner and bedtime. Results: At about 24 hours, 27% had moderate to severe pain. All patients showed significant pain reduction after initial root canal therapy. The ibuprofen group showed a rebound in pain the following day. Males had more rebound pain compared to females. Anaprox DS and the combination of Ibuprofen and Vicodin showed the most pain reduction at all time periods. In our study, the results suggested that pulp vitality had little effect on post operative pain. Conclusion: Primary endodontic treatment will greatly decrease the pain felt by the patient. High doses of Ibuprofen followed by an abrupt stop might lead to a rebound in pain. Tooth vitality did not seem to affect post operative discomfort, nor did patient gender. More research using this model and analgesic combination is necessary to ensure statistically significant results.