Comparison of effect of intracanal use of ketorolac tromethamine and dexamethasone with oral ibuprofen on post treatment endodontic pain

The purpose of this study was to compare the pain-reducing efficacy of dexa methasone and ketorolac tromethamine when used as an intracanal medication, with oval ibuprofen and a placebo. An additional objective was to establis h if any relationship exists between the incidence and severity of pretreat ment pain and the incidence and severity of postinstrumentation pain. A tot al of 48 patients who presented to the University of Illinois postgraduate endodontic clinic were invited to participate. Patients were randomly assig ned to 1 of 4 groups: oval ibuprofen, placebo, dexamethasone, or ketorolac tromethamine. Patients were asked to evaluate their pretreatment pain when they presented to the clinic with a Visual Analog Scale. The root canal tre atment was performed in two appointments. The first appointment consisted o f cleansing and shaping of the canal/s and placement of an intracanal medic ation. All teeth were closed with a sterile cotton pellet and IRM. Each pat ient was sent home with a Visual Analog Scale to fill out at 6, 12, 24 and 48 h after initiation of therapy. At the 12-h period, both dexamethasone an d ketorolac provided statistically significant better pain relief than plac ebo. At the 24-h period, only ketorolac demonstrated better pain relief tha n the placebo. There were no statistically significant differences among th e groups at 6 and 48 h. Although ibuprofen pain ratings were less than the placebo at all time points, the reduction was not significant. In addition, no significant differences were demonstrated between ibuprofen and either dexamethasone or ketorolac.