The ability of intracanal use of two
nonsteroidal anti-inflammatory agents--
diclofenac and
ketoprofen--with and without
hyaluronidase to control posttreatment
pain was compared with that of a placebo control in a double-blind study of 760 subjects. The study was carried out on originally asymptomatic and symptomatic teeth that required endodontic
therapy. Endodontic treatment was completed in three visits during which medications were placed into the canal either at the end of the first visit (postextirpation) or the second visit (postinstrumentation). Patients subjectively rated their
pain on a scale of 1 to 4 as none, mild, moderate, and severe. The ratings were done preoperatively and at 2, 4, 8, and 12 hours postoperatively on the first day as well as on the second and third days. Statistical analysis of the data revealed that both
diclofenac and
ketoprofen significantly reduced the mean
pain score in originally asymptomatic and symptomatic cases and were significantly superior to the placebo until the end of the study. Postendodontic
pain occurred with less frequency when the teeth were treated with
diclofenac, but
diclofenac-treated and
ketoprofen-treated cases were not significantly different at controlling postendodontic
pain. An increase in the number of patients who reported complete absence of
pain was recorded when
hyaluronidase was added to the study medications. However, the difference between the medications and medications-
hyaluronidase was not of statistical significance.