Comparative evaluation of the effect of various transdermal patches and oral nonsteroidal anti-inflammatory drugs on postoperative endodontic pain and quality of life - A placebo-controlled randomized clinical trial.

Aim: To evaluate the efficacy of preemptive ketoprofen transdermal patch (KTP) administration against oral ibuprofen in reducing postoperative endodontic pain following single-visit endodontic treatment of mandibular molars with symptomatic irreversible pulpitis and apical periodontitis. Materials and Methods: Patients fulfilling the eligibility criteria were randomized into four groups. Group 1 received oral ibuprofen; Group II received a placebo oral tablet, Group III received a KTP, and Group IV received a placebo patch 1 h before commencement of root canal treatment. Pain scores were evaluated at baseline, 4, 6, 12, 24, 48, and 72 h after the treatment. Oral Health-related Quality of Life (OHRQoL) was assessed at baseline and 2 weeks after the treatment. Results: All the groups had a significantly lower incidence of postoperative pain and improved OHRQOL. At 4 h, the pain level was significantly lower with an oral ibuprofen tablet, and at 12 and 24 h, it was significantly lower with transdermal ketoprofen. There was no significant difference in the OHRQoL among the four groups. Conclusion: Oral ibuprofen is most effective at the 4-h interval, whereas transdermal ketoprofen has the best pain reduction in the 12-24-h window due to its sustained-release pharmacokinetics. A ketoprofen patch is a promising alternative for postoperative pain management.