title: Double-blind Randomized Placebo-controlled Clinical Trial of Efficiency of Nonsteroidal Anti-inflammatory Drugs in the Control of Post-endodontic Pain.
abstract: BACKGROUND
  The present clinical trial aimed to evaluate the efficiency of paracetamol alone and in combination with 3 different nonsteroidal anti-inflammatory drugs for control of post-endodontic pain.
  
  
  METHODS
  The inclusion criteria were moderate to severe pain of irreversible pulpitis, by using the Verbal Rating Scale and a 4-10 score on the Numerical Rating Scale, on anterior or premolar teeth, as well as the absence of signs and symptoms of apical periodontitis. One hundred eighty-five trial medications with placebo were prepared, and 170 participants completed the trial. There were 5 groups. P-group received 4 gelatinous capsules of a single dose of paracetamol alone. The IP-group received similar capsules of a single dose of combined ibuprofen/paracetamol. MP-group received combined mefenamic acid/paracetamol, and DP-group received combined diclofenac K/paracetamol. A Plb-group received doubled gelatinous capsules with no medications as a single dose, which had the same weight and appearance as the medicated capsules, to be the placebo.
  
  
  RESULTS
  Pain intensity was measured after initial endodontic therapy and instrumentation by using the Verbal Rating Scale and Numerical Rating Scale. IP-group (ibuprofen/paracetamol) had the most pain reduction, followed by DP-group (combined diclofenac K/paracetamol), then MP-group, followed by P-group, whereas Plb-group had the least pain reduction (P < .05).
  
  
  CONCLUSIONS
  The combination of ibuprofen/paracetamol, taken immediately after initial endodontic therapy and root canal preparation in teeth with irreversible pulpitis, reduced post-endodontic pain (ClinicalTrials.gov no.: NCT02417337).
authors.affiliation: Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan; Faculty of Dentistry, King Khalid University, South Region/Abha, Kingdom of Saudi Arabia.
authors.forename: Wail M
authors.initials: WM
authors.lastname: Elzaki
authors.affiliation: Department of Clinical Dental Science, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia. Electronic address: nhabubakr@pnu.edu.sa.
authors.forename: Neamat H
authors.initials: NH
authors.lastname: Abubakr
authors.affiliation: Department of General Dental Practice, Faculty of Dentistry, Health Sciences Center, Kuwait University, Safat, Kuwait.
authors.forename: Hassan M
authors.initials: HM
authors.lastname: Ziada
authors.affiliation: Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan.
authors.forename: Yahia E
authors.initials: YE
authors.lastname: Ibrahim
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004008:Diclofenac / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008528:Mefenamic Acid / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D010919:Placebos / Q000008:administration & dosage; D011671:Pulpitis / Q000628:therapy; D018915:Root Canal Preparation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D012390:Root Canal Therapy / Q000009:adverse effects / Q000379:methods
chemical_list: D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D010919:Placebos; D004008:Diclofenac; D000082:Acetaminophen; D008528:Mefenamic Acid; D008012:Lidocaine; D007052:Ibuprofen
keywords: Endodontic; Numerical Rating Scale; Verbal Rating Scale; irreversible pulpitis; pain; randomized clinical trial