Official publication of Rawalpindi Medical University
A Comparative Evaluation Of Premedication With Flurbiprofen And Prednisolone On Post Endodontic Pain In Teeth With Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial

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Haq U ul, Maqbool H, Rizwan Z, Sajid K, Nazir K, Khattak S ur R. A Comparative Evaluation Of Premedication With Flurbiprofen And Prednisolone On Post Endodontic Pain In Teeth With Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial. JRMC [Internet]. 2023 Sep. 26 [cited 2024 May 26];27(3). Available from:


Background: Root canal treatment is an endodontic procedure that encompasses cleaning & shaping i.e. preparation of root canals followed by obturation of the prepared canals. Pain is a very common sensation that occurs few hours after root canal treatment (RCT).

Objective: To evaluate and compare the efficacy of premedication with flurbiprofen and prednisolone on post-endodontic pain in teeth with symptomatic irreversible pulpitis.

Materials and Methods: It is a randomized control trial study conducted in the department of Operative Dentistry & Endodontics, Sardar Begum Dental College, & Hospital Peshawar. Patients were randomly allocated into two groups i.e. A and B using coin flip technique. Thirty minutes before starting the endodontic therapy, single pretreatment dose of Flurbiprofen (100mg) was given to patients in Group A and Prednisolone (30mg) to patients in Group B. Patients’ pain intensity experience was measured using the visual analog scale (VAS) after root canal treatment. They were instructed to complete a pain diary at specific intervals (i.e. at 6, 12 and 24 hours after the commencement of treatment) in order to determine efficacy in both groups.

Results: As per efficacy in both groups, in Group A, 44 (55%) showed effective results whereas in Group B, only 20 (25%) patients showed effective results.

Conclusion: Single pretreatment dose of flurbiprofen has a more sustained effect in reducing post-endodontic pain as compared to prednisolone.


Vieyra JP, Enriquez FJ, Acosta FO, Guardado JA. Reduction of post-endodontic pain after one-visit root canal treatment using three irrigating regimens with different temperature. NJCP. 2019; 1(22): 1.

Shabbir J, Qazi F, Farooqui W, Ahmed S, Zehra T, Khurshid Z. Effect of Chinese propolis as an intracanal medicament on post-operative endodontic pain: a double-blind randomized controlled trial. IJERPH. 2020; 17(2):445.

Gyanani H, Chhabra N, Parmar GR. Comparative assessment of efficacy of two different pretreatment single oral doses of betamethasone on inter-appointment and postoperative discomfort: An in vivo clinical evaluation. JCD. 2016; 19(6):564.

Metri M, Hegde S, Bhandi S. Effect of pretreatment diclofenac sodium on postendodontic pain: A randomised controlled trial. JCD. 2016; 19(1):7.

Praveen R, Thakur S, Kirthiga M. Comparative evaluation of premedication with ketorolac and prednisolone on postendodontic pain: a double-blind randomized controlled trial. JOE. 2017; 43(5): 667-73.

Perković I, Romić MK, Perić M, Krmek SJ. The Level of Anxiety and Pain Perception of Endodontic Patients. Acta Stomatol Croat. 2014; 48(4):258-67.

Maroof K, Zafar F, Ali H, Naveed S. Flurbiprofen: a potent pain reliever. J Bioequiv Availab. 2015; 7(1):056-8.

Liberman AC, Budziñski ML, Sokn C, Gobbini RP, Steininger A, Arzt E. Regulatory and mechanistic actions of glucocorticoids on T and inflammatory cells. Front endocrinol. 2018; 16(9):235.

Mokhtari F, Yazdi K, Mahabadi AM, Modaresi SJ, Hamzeheil Z. Effect of premedication with indomethacin and ibuprofen on postoperative endodontic pain: a clinical trial. Iran Endod J. 2016; 11(1):57.

Elkhadem A, Ezzat K, Ramadan M, AbdelGhaffar S, Khamis D, Hassan A, Abdel‐Mawgoud A, Mamdouh A, AbouZeid M, Amin S. The effect of preoperative oral administration of prednisolone on postoperative pain in patients with symptomatic irreversible pulpitis: a single‐centre randomized controlled trial. Intl Endod J. 2018; 51:e189-96.

Muneer M, Parveen N, Ghaffar A, Iqbal Q. Effectiveness of pretreatment prednisolone on postendodontic pain in comparison to placebo. PODJ. 2018; 38(1):110-2.

Memon NA, Memon MR, Feroz A. Assessment of the interappointment pain by using two different intracanal medicaments. PODJ. 2013; 33: 1

Chagas Carvalho Alves N, Raiane Mamede Veloso S, de Andrade Silva S, de Almeida AC, Tavares Velozo Telles C, Romeiro K, de Melo Monteiro GQ, de Albuquerque DS. Influence of occlusal reduction on pain after endodontic treatment: A systematic review and meta-analysis. Scient repo. 2021; 11(1):1-1.

Vishwanathaiah S, Maganur PC, Khanagar SB, Chohan H, Testarelli L, Mazzoni A, Gupta AA, Raj AT, Bhandi S, Mehta D, Patil S. The incidence and intensity of postendodontic pain and flareup in single and multiple visit root canal treatments: A systematic review and meta-analysis. App Sci. 2021; 11(8):3358.

Sheikh H, Ahmed MA, Jouhar R, Choudhry Z. comparison of post instrumentation pain in teeth during root canal treatment with or without occlusal reduction. PODJ. 2015; 35(4): 1.

Agnihotry A, Thompson W, Fedorowicz Z, van Zuuren EJ, Sprakel J. Antibiotic use for irreversible pulpitis. Coch Data Syst Rev. 2019; 4(5): 3-8.

Radeva E. Emergency treatment of irreversible pulpitis. JIMAB. 2008; 14(2):3-4.

Santini M, Da Rosa RA, Ferreira MB, Barletta F, Do Nascimento AL, Weissheimer T, Estrela C, So MV. Medications used for prevention and treatment of postoperative endodontic pain: a systematic review. Europ Endod J. 2021; 6(1):15.

Konagala RK, Mandava J, Pabbati RK, Anupreeta A, Borugadda R, Ravi R. Effect of pretreatment medication on postendodontic pain: a double-blind, placebo-controlled study. JCD. 2019; 22(1):54.

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Copyright (c) 2023 Dr Umair ul Haq, Dr Hassan Maqbool, Dr Zarnab Rizwan, Dr Khadija Sajid, Dr Kiran Nazir, Dr Shakeel ur Rahman Khattak