Study on the Outcome of Preoperative Administration of Single-Dose Ketorolac, Ibuprofen 400mg and Placebo on Postoperative Pain in Teeth with Irreversible Pulpitis and Apical Periodontitis

Aim: To compare the outcome of preoperative administration of single-dose ketorolac, ibuprofen 400mg, and placebo on postoperative pain in teeth with irreversible pulpitis and apical periodontitis.

Introduction: It is well recognized that, in general, preoperative pain is the principal factor in determining the level of postoperative pain. The occurrence of postoperative pain of mild intensity is not an occasional event even when endodontic treatment has followed suitable standards.

Methodology: A total of 54 patients (29 women and 25 men), 18 to 60 years of age with 54 eligible teeth consented to participate in the study, were divided into three groups (n = 18) according to the type of preoperative drug administrated, as follows: Group A: ketorolac 10mg, Group B: Ibuprofen 400mg, and Group C: A placebo (capsule filled with sugar). The data were analyzed with a chi-square test, one-way ANOVA. The Kruskal-Wallis nonparametric test was applied to compare the incidence of postoperative pain. The level of significance adopted was 5% (p = 0.05).

Results: On Days 1 and 3, preoperative administration of analgesic resulted in lower pain levels than the placebo. On Days 5 and 7, however, while preoperative administration of analgesic still resulted in less pain than the placebo, there was no significant difference between the analgesic and placebo (p= 0 .05). Ketorolac and Ibuprofen 400 mg showed clinically significant relief in pain for the next three days compared with the placebo. In addition, no significant differences were demonstrated between ketorolac and ibuprofen 400 mg (Table 3).

Conclusion: A single dose of ketorolac was as effective or as safe as NSAID for the relief of pain after operations on postoperative pain in teeth with symptomatic apical periodontitis.