Effect of pre-treatment systemic antibiotics on post-operative pain following single-visit root canal therapy in vital mandibular first premolars: A randomized controlled trial.

Most post-endodontic pain can be effectively managed pharmacologically without antibiotic use. However, some clinicians continue to prescribe antibiotics prophylactically, driven by concern over flare-ups or patient expectations. Therefore, it is of interest to evaluate the effect of pre-treatment systemic antibiotic prophylaxis on post-operative pain following single-visit root canal therapy. A randomized controlled trial was conducted involving 60 systemically healthy patients requiring root canal treatment in vital mandibular first premolars. Participants were divided into two groups: Group A received a single pre-operative dose of 500 mg amoxicillin one hour prior to treatment, while Group B received no antibiotic. Subjects who received antibiotics reported significantly lower pain scores during the initial 24 hours compared to the non-antibiotic group (p < 0.05). Thus, pre-operative systemic antibiotics may provide early post-operative pain relief in vital teeth, but antibiotic use should be judicious and reserved for specific clinical indications.