The adult participants who report in out-patient department (OPD) of Operative Dentistry
at Dow International Dental College with the symptoms of irreversible pulpitis will be
screened for the participation in the study. A detailed history will be taken which will
be followed by clinical examination and complemented with sensibility testing with Endo
Ice or electric pulp test. Radiographic analysis will also be done to confirm the
diagnosis to assess for factors pertaining to exclusion and inclusion criteria. Verbal
and written informed consent will be taken from all the participants.
Randomization: The participants will be randomly divided into 3 groups by envelope
method.
Group A will receive premedication of Oral tramadol 100mg, Group B will receive
premedication of oral naproxen 550mg. Both medicines will be given 60 minutes prior to
the local anesthesia administration. The third group, Group C, will be the control group
and no active preoperative medication will be given to these participants. A placebo will
be given to these participants. These medications will be given as a single intervention
only.
Blinding: Clinician and participants both will be blind to the medicine given to the
participants. Participants will be allowed to pick envelopes and a paramedical staff will
be trained in giving medication to the participants.
Pain scores will be recorded by asking the participant to rate their pain on a scale
ranging from 0 to 10 before medication and then after 15 minutes, 30 minutes and 60
minutes of administering the premedication. Pain score will also be recorded after 10
minutes of the administration of Inferior alveolar nerve block (IANBs) and buccal nerve
block & during deroofing process of chamber opening.
Two cartridges of Lidocaine 1.8 ml having a concentration of 1:100,000 of Epinephrine
will be used for administration of regional anesthesia. Access opening will be performed
under rubber dam isolation with a Mani number 245 bur in a high-speed hand piece with
copious water irrigation. Sodium hypochlorite (5.25%) will be used as a standard root
canal irrigation solution.Pulpectomy will be performed with Mani K-files (8-25) till
respective working lengths of the teeth under study.
To assess the post-operative pain, a proforma and pain intensity scale will be provided
to the participants for self recording at 6, 24, 48 and 72 hours after the procedure. The
participants will return the proforma to an intern on 3rd day to be assessed by an intern
supervised by the principal investigator.
(For this research, "The investigators will be offering As per need analgesic for
breakthrough pain. Participants will be offered brufen 400mg as needed. The participants
will be advised to mark breakthrough pain on VAS at the time of taking medicine).
The participants will also be monitored for the adverse effects of these medications
(nausea, vomiting, dizziness, drowsiness) as a secondary outcome .at above-mentioned
time-intervals.