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Objective: The management of postoperative endodontic pain (PEP) is essential to contemporary endodontic practice. Diclofenac and ibuprofen (IBU) are two of the most widely-used non-steroidal anti-inflammatory analgesics. However, their comparative data are neither sufficient nor conclusive. This prospective randomised clinical trial aimed to compare the analgesic efficacy of diclofenac potassium (DFK) with IBU on PEP in maxillary and mandibular first molars diagnosed with irreversible pulpitis after single-visit non-surgical root canal treatment., Methods: Sixty-four patients were randomised into two groups of DFK (n=32) and IBU (n=32), using the stratified permuted randomisation method, and 61 participants completed the trial. After root canal treatment, patients randomly received IBU 400 mg every 6 hours (n=31) or DFK 50 mg every 8 hours (n=30) for 24 hours. Patients recorded their pain level on 0-100 mm visual analogue scales (VAS) at 2, 4, 6, 12, and 24 hours after the treatment. Recorded VAS scores and the number of pain-free patients (VAS<5) were compared between the two groups. A generalised linear estimation equation model, Chi-Square test, and Mann-Whitney U test were used to analyse the data., Results: The mean overall PEP score was statistically significantly lower in the DFK group than the IBU group with a p value of 0.030. Pain scores at 2 (p=0.034), 4 (p=0.021), and 24 hours (p=0.042) after the treatment were also significantly lower for DFK than IBU. The number of pain-free patients was also significantly higher in the DFK group at 2-hour (p=0.015) and 4-hour (p=0.048) time points and overall (p=0.013) compared to the IBU group. There was no adverse effect observed in either group., Conclusion: Based on the results, taking multi-dose DFK 50 mg by the clock had better analgesic outcomes than multi-dose IBU 400 mg for PEP management. (EEJ-2022-01-07).

Objective: A systematic review and meta-analysis were conducted to determine whether there are postoperative pain differences resulting from rotary and reciprocation engine-driven instrumentation motions in non-surgical endodontic treatment or retreatment at 12, 24, and 48 hours., Methods: Four electronic databases (PubMed, Embase, Cochrane Library, and Scopus) were searched to identify randomised controlled trials that compared the effects of rotary and reciprocating instrumentation motions on postoperative pain. Two authors independently screened the search results, extracted the data, and assessed the quality using the Cochrane risk of bias tool. Due to numerous variables across studies, the random effect inverse variance method for meta-analysis was applied. When significant heterogeneity among studies was present, the random effects multi-variable meta-regression analysis was performed to determine the source of heterogeneity., Results: At all time intervals, the incidence of postoperative pain was higher in the reciprocating instrumentation group, but was not statistically significant. There was no significant difference in the analgesic intake between groups. Meta-regression analysis determined study population sizes as a significant heterogeneous factor, while significance was not observed for preoperative pain or the pulpal diagnosis., Conclusion: There was no difference in postoperative pain at 12, 24, and 48 hours after non-surgical root canal treatment and retreatment, using reciprocating or rotary instrumentation motions.