A comparative study between the efficacy of tramadol, celecoxib and ibuprofen in pain control after root canal therapy of tooth

Background : Root canal therapy of teeth can relief the endodontic pain, but post-endodontic pain and discomfort are its undesirable effects. There are many studies on various drugs for alleviation of post-endodontic pain. The aim of this study was to compare the analgesic effect of tramadol, celecoxib and ibuprofen in vital teeth.

  Materials & Method : In this double blind randomized clinical trial study, 104 patients with vital first mandibular molar tooth were selected. The patients were divided in to four groups, tramadol (A), celecoxib (B), ibuprofen (C) and placebo (D). The similar capsules were filled with50mg tramadol HCL, 100mg celecoxib, 400mg ibuprofen and starch . Each patient received randomly one capsule one hour before treatment. If the pain persists, the patient received one tablet of 325 mg acetaminophen every 6 hours. The groups were controlled for 3 days. The data were collected one hour before and 6, 12, 24, 48, 72 hours after treatment. Results were analyzed using kruskal-wallis and Mann-Whitney U tests.

  Results : The results showed that after 12 (p=0.039) and 24(p=0.024) hours of treatment, tramadol was better in pain relief in comparison with other groups and there was one difference between tramadol and ibuprofen after treatment after 12 hours (p=0.013). But there was no significant deference between drug groups at 6, 48 and 72 hour after treatment.

  Conclusion : Tramadol prescription in comparison with celecoxib, ibuprofen and placebo has greater analgesic effect after root canal therapy in vital teeth. In addition tramadol may be a good medicine for post-endodontic pain control.