Comparative evaluation of efficacy of proteolytic enzymes and ibuprofen in postoperative pain control after single-visit endodontics: A randomized trial

Aim: This study evaluated and compared the effect of trypsin–chymotrypsin complex, serratiopeptidase, and ibuprofen on pain outcome after single-visit endodontics (SVE) treatment. Methods: Thirty-nine patients were selected having their mandibular first molars diagnosed with symptomatic irreversible pulpitis requiring SVE therapy. The patients were randomly and equally allocated to ibuprofen, trypsin–chymotrypsin, and serratiopeptidase group. A SVE procedure was carried out for all the groups with standard protocol. Patients allocated to each group were prescribed the respective drug in the desired dosage postoperatively. Postoperative pain score at different time intervals was collected from participants using a numerical scale. Collected data were analyzed using Kruskal–Wallis, with the significance level of P = 0.05. Results: All three drugs showed the effectiveness in reducing postoperative pain. The intergroup comparison at all time intervals showed an insignificant difference ( P > 0.05 for all intervals). At 6 h, mean pain scores were 4.31 (ibuprofen), 3.85 (trypsin–chymotrypsin), and 4.23 (serratiopeptidase) ( P = 0.823). Trypsin–chymotrypsin and serratiopeptidase demonstrated statistically comparable postoperative pain reduction to ibuprofen. Conclusion: Trypsin–chymotrypsin and serratiopeptidase exhibit comparable efficacy as that of nonsteroidal anti-inflammatory drugs, i.e., ibuprofen. Application of trypsin–chymotrypsin or serratiopeptidase was well tolerated, with no adverse events noted.