4. Discussion
pulpitis, postoperative pain, allodynia, pain, gastrointestinal pain, tooth on postoperative pain, tooth, NRS
PULPITIS
This study compared the efficacy of KTP and ibuprofen tablets for pain control after endodontic treatment of mandibular first and second molars with irreversible pulpitis. The severity of preoperative pain and pulpal diagnosis are among the factors that can affect postoperative pain [In the present study, the NRS was used for quantification of pain due to its slightly superior efficacy to the visual analog scale [Evidence shows that preoperative pain and periapical allodynia (sensitivity to percussion) can significantly affect postendodontic pain [Assessment of the effect of gender on the postoperative pain score by GEE in the present study showed that although females in both groups had a higher pain score than males, this difference did not reach statistical significance, which was in line with a previous study [GEE also assessed the effect of type of tooth on postoperative pain, and it showed that although patients with a second molar with irreversible pulpitis had higher postoperative pain than those with a first molar with irreversible pulpitis, this difference was not significant. No previous study is available on this topic to compare our results with.In the present study, 2 patients in the ibuprofen tablet group had mild gastrointestinal pain, which was reported in 12 out of 16 patients in a study by Mangal et al. [In the current study, although the mean preoperative pain score was higher in the KTP group, the difference between the two groups was not significant. In both groups, the reduction in the pain score in both the first (2–10 hours) and second (10–48 hours) intervals was significant. The interaction effect of time and medication was not significant at any interval in any group, which means that the pattern of pain reduction over time was the same in both the groups.As mentioned earlier, several studies have evaluated the effects of NSAIDs in the form of transdermal patch on pain after tooth extraction [Moreover, controversy exists in the literature regarding the efficacy of transdermal patches. Three studies on pain control by oral intake of diclofenac sodium and its transdermal patch following periodontal flap surgery showed that its transdermal patch could have a higher [To the best of the authors' knowledge, this study is the first to assess the efficacy of KTP for postendodontic pain control, which is a major strength of this study. Assessment of the effect of gender on postoperative pain was another strength of this study.This study had some limitations as well. Absence of a placebo group was a limitation of this study. However, it was not ethically possible to have a placebo group. Also, subjective nature of pain is another limitation, which cannot be controlled for. Moreover, the age range of the study population was high, which can affect the pain threshold.Future studies on a larger sample size are required to increase the generalizability of the results.