Introduction:Mandibular molar teeth with acute irreversible pulpitis pose challenges during root canal treatment (1) success of local anesthesia (2) post-operative pain. The primary aim of this study was to assess the effect of pre-operative ketorolac tromethamine oral administration on intra-/post-operative pain. Secondary objective was to evaluate the effect of different anesthetic solutions and irrigants on the same.
Materials and Methods:128 patients with irreversible pulpitis associated with carious mandibular molar teeth were enrolled. All patients were administered 10 mg of ketorolac tromethamine prior to local anesthestic injections. The local anesthetics used were 2% lignocaine and 4% articaine. Three irrigation solutions were used – saline, 3% sodium hypochlorite and dexamethasone. Pain was assessed using a 10-point Visual Analog Scale.
Results:The mean intra-operative pain scores for the lignocaine and articaine groups were 2.43 (± 2.37) and 3.19 (± 3.01), respectively. The post-operative pain incidence in the lignocaine and articaine groups was 23.8% (15 patients) and 39.7% (25 patients) (P = 0.057) respectively. Sodium hypochlorite irrigation in the lignocaine group had the lowest mean 24 hr post-operative pain score of 0.57 ± 0.21 whereas in the articaine group, it had the highest mean 24 hr post-operative score of 1.36 ± 1.76.
Conclusion:In conclusion, the combination of pre-operative ketorolac with lignocaine was effective in controlling post-operative pain. Single visit root canal treatment with pre-operative ketorolac tromethamine and lignocaine inferior alveolar nerve block and additional injections combined with sodium hypochlorite or dexamethasone irrigation was very effective in the management of symptoms associated with acute irreversible pulpitis in mandibular molar teeth.
Keywords:4% Articaine; 2% Lignocaine; Buccal Nerve Infiltration; Inferior Alveolar Nerve Block; Intra-Ligamentary Injection; Ketorolac Tromethamine; Root Canal Irrigants; Single Visit Root Canal Treatment

Fear and anxiety from dental procedures could reduce the child’s cooperation during the treatment. Many parents are eager to accompany their children to the treatment room. This action not only makes the children more aggressive and disobedient but also interferes with the continuity of the treatment. In other words, the presence of parents can increase the child’s behavioral disorder.
Keywords:Fear and Anxiety; Parents Accompaniment; Aggressive; Disobedient; Child’s Behavior