Assessing the efficacy of Celebrex premedication on pain during and after endodontic treatment in teeth with symptomatic irreversible pulpits

Owing to the painful nature of endodotnic treatment in teeth with irreversible pulpits, administration of an analgesic and anti-inflammatory could help to lessen the perception of pain, hence decreasing the patient apprehension.

Previous clinical trials have shown that the use of NSAIDS as a premedication prior to endodontic treatment was effective in reducing the pain and increasing the anesthetic success, since as high as 80% of the patients with pre-operative pain experience pain after endodontic treatment.

In this study, Celebrex (Celecoxib) 200mg will be given to the patients 1 hour before initiation of the treatment, and its effect on reducing the pain will be compared with a placebo.

Celebrex being a selective COX-2 inhibitor, it will spare the physiological tissue prostaglandin production while inhibiting the inflammatory prostaglandin production thus allow for effective analgesia with fewer side effects than Non-Selective NSAIDS (nsNSAIDS).

Inclusion Criteria:

• Medically free patients
• Patients able to understand Visual Analogue Scale and sign the informed conset

Mandibular molar teeth with:

• Preoperative sharp pain
• Vital pulp tissue
• Normal peripaical radiographic appearance or slight widening of the lamina dura

Exclusion Criteria:

• Patients allergic to NSAIDS
• Pregnant females
• Patients having significant systemic disorder
• Patients with psychological disturbances
• Patients with bruxism or clenching

Teeth that have:

• Associated with swelling or fistulous tract
• Acute or chronic periapical abscess
• Greater than grade I mobility
• Periodontitis
• No possible restorability
• previous endodontic treatment