Iranian Center for Endodontic Research, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Endodontics, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Eur Endod J. 2023 Mar;8(2):133-139. doi: 10.14744/eej.2022.45238.
The management of postoperative endodontic pain (PEP) is essential to contemporary endodontic practice. Diclofenac and ibuprofen (IBU) are two of the most widely-used non-steroidal anti-inflammatory analgesics. However, their comparative data are neither sufficient nor conclusive. This prospective randomised clinical trial aimed to compare the analgesic efficacy of diclofenac potassium (DFK) with IBU on PEP in maxillary and mandibular first molars diagnosed with irreversible pulpitis after single-visit non-surgical root canal treatment.
Sixty-four patients were randomised into two groups of DFK (n=32) and IBU (n=32), using the stratified permuted randomisation method, and 61 participants completed the trial. After root canal treatment, patients randomly received IBU 400 mg every 6 hours (n=31) or DFK 50 mg every 8 hours (n=30) for 24 hours. Patients recorded their pain level on 0-100 mm visual analogue scales (VAS) at 2, 4, 6, 12, and 24 hours after the treatment. Recorded VAS scores and the number of pain-free patients (VAS<5) were compared between the two groups. A generalised linear estimation equation model, Chi-Square test, and Mann-Whitney U test were used to analyse the data.
The mean overall PEP score was statistically significantly lower in the DFK group than the IBU group with a p value of 0.030. Pain scores at 2 (p=0.034), 4 (p=0.021), and 24 hours (p=0.042) after the treatment were also significantly lower for DFK than IBU. The number of pain-free patients was also significantly higher in the DFK group at 2-hour (p=0.015) and 4-hour (p=0.048) time points and overall (p=0.013) compared to the IBU group. There was no adverse effect observed in either group.
Based on the results, taking multi-dose DFK 50 mg by the clock had better analgesic outcomes than multi-dose IBU 400 mg for PEP management. (EEJ-2022-01-07).
术后根管治疗疼痛（PEP）的管理对于当代根管治疗实践至关重要。双氯芬酸和布洛芬（IBU）是两种最广泛使用的非甾体抗炎镇痛药。然而，它们的比较数据既不充分也没有结论性。本前瞻性随机临床试验旨在比较双氯芬酸钾（DFK）和 IBU 在单次就诊非手术根管治疗后诊断为不可复性牙髓炎的上颌和下颌第一磨牙 PEP 中的镇痛效果。
采用分层随机化方法将 64 名患者随机分为 DFK 组（n=32）和 IBU 组（n=32），61 名参与者完成了试验。根管治疗后，患者随机接受 IBU 400 mg 每 6 小时（n=31）或 DFK 50 mg 每 8 小时（n=30）治疗 24 小时。患者在治疗后 2、4、6、12 和 24 小时使用 0-100mm 视觉模拟量表（VAS）记录疼痛水平。比较两组之间的记录 VAS 评分和无疼痛患者的数量（VAS<5）。使用广义线性估计方程模型、卡方检验和曼-惠特尼 U 检验分析数据。
DFK 组的总体 PEP 评分明显低于 IBU 组，p 值为 0.030。治疗后 2（p=0.034）、4（p=0.021）和 24 小时（p=0.042）的疼痛评分也明显低于 IBU。DFK 组在 2 小时（p=0.015）和 4 小时（p=0.048）时间点以及总体（p=0.013）的无疼痛患者数量也明显高于 IBU 组。两组均未观察到不良反应。
根据结果，每 8 小时服用一次 DFK 50mg 比每 6 小时服用一次 IBU 400mg 对 PEP 管理具有更好的镇痛效果。（EEJ-2022-01-07）。
