A comparative triple-blinded clinical trial upon preventive analgesic effectiveness of ibuprofen, naproxen and sulindac following pulp treatment

  Post-endodontic pain is one of the main problems for both patients and clinicians. The purpose of this study was to compare the analgesic effect of single doses of three oral medications of ibuprofen, naproxen and sulindac in management of postoperative pain following root canals treatment (RCT).
Subjects and This randomized controlled triple-blinded study was conducted on 100 patients with irreversible pulpitis. The patients were randomly divided into four groups of 25 patients each: the control group received placebo and three experimental groups received single dose of either ibuprofen (400 mg), naproxen (500 mg) or sulindac (200 mg) 30 minutes before treatment. The intensity of pain was measured base on visual analog scale (VAS) at 0, 3, 6, 12, 24, 36 and 72 hours after routine root canals treatment. The pain scores were not significantly different immediately after intervention (time 0) between the control and study groups. At the 3,6,12 and 24 h postoperative intervals, the intensity of pain in the experimental groups was significantly lower than placebo (P<0.001). Ibuprofen was significantly more effective than naproxen and sulindac at 3 and 6 h postoperative (P<0.05). The analgesic effect of naproxen and sulindac were similar at all time points. A single oral dose of ibuprofen, naproxen and sulindac before root canal treatment reduced postoperative pain. However, premedication with ibuprofen is more effective in the first 6 hrs in controlling post-endodontic pain than naproxen and sulindac.