Comparative Evaluation of the Efficacy of Two Different Analgesics on Postoperative Pain after Root Canal Treatment: A Randomised Controlled Trial

Abstract Background: Postoperative pain remains a common challenge in endodontics, often indicating treatment failure. Preoperative analgesic strategies, particularly NSAID combinations, are employed to mitigate post-instrumentation discomfort. This study evaluates and compares the analgesic efficacy of Aceclofenac plus Paracetamol versus Ibuprofen plus Paracetamol in managing postoperative pain following root canal treatment. Materials and Methods: This randomized controlled trial included 36 patients with symptomatic irreversible pulpitis, randomly assigned to two groups. Group 1 received Aceclofenac (100 mg) with Paracetamol (500 mg), while Group 2 received Ibuprofen (400 mg) with Paracetamol (500 mg). Standard endodontic procedures were performed under local anesthesia and rubber dam isolation. Postoperative pain was assessed using the Visual Analog Scale (VAS) on Day 1 and Day 4. Data were analyzed using independent-sample t-tests, with a significance level set at p<0.05. Results: The preoperative VAS scores were comparable between groups (p=0.262). At 24 hours, the Ibuprofen + Paracetamol group showed a significantly greater reduction in pain (p=0.0014). By Day 4, pain scores continued to decline in both groups, with the Ibuprofen combination maintaining a statistically significant advantage (p=0.0456). The findings indicate that the Ibuprofen-Paracetamol combination provides superior and sustained analgesic effects compared to Aceclofenac-Paracetamol. Conclusion: The combination of Ibuprofen with Paracetamol demonstrates enhanced early and prolonged postoperative analgesia in endodontic patients, supporting its clinical utility in managing post-treatment pain. Further research is warranted to explore the underlying mechanisms and long-term outcomes.