The effects of calcium hydroxide and diclofenac sodium as root canal medicaments on post-endodontic pain: a double-blinded, parallel group, randomized controlled clinical trial.

The aim of this study was to evaluate the effects of calcium hydroxide (CH), diclofenac sodium (DCS), and their combination (CH + DCS) as intracanal medicaments on post-endodontic pain in teeth diagnosed with symptomatic irreversible pulpitis. This study included 90 participants with one first or second mandibular molar with symptomatic irreversible pulpitis. They were randomly divided into three groups according to intracanal medicament (CH, DCS, CH + DCS) (n = 30). The participants were asked to rate their pain intensity on a VAS as none, mild, moderate, severe, or very severe after the 7 days following the first visit. Patients were also asked to record the number of prescribed analgesic medication tablets taken. Statistical analysis was performed using the Kruskal-Wallis test, the Friedman test, the Wilcoxon signed-rank test, and the Chi-square test. The significance level was established at 0.05. Ninety patients were analyzed at the 1-week follow-up. The pain scores gradually decreased after the first visit in all medication groups compared to the preoperative period (p < 0.05). DCS was more effective at reducing post-treatment pain when used alone than were DCH + CH and CH (p < 0.05). The number of patients who used postoperative analgesics was similar across the groups (p > 0.05). Compared with CH, the use of DCS alone as an intracanal medicament is more effective in reducing postoperative pain. The significant effect of DCS alone in reducing postoperative pain scores supports its consideration as an alternative to CH in endodontic treatment. ClinicalTrials.gov ID NCT06632015, Registration Date 10 July 2024 (retrospectively registered).