The goal of this randomized clinical trial is to learn the effect of using local corticosteroids and maintaining apical patency in reducing post-preparation pain in patients with acute irreversible pulpitis in molar teeth. The main question it aims to answer is:

• How effective are using local corticosteroids and maintaining apical patency in reducing post-preparation pain in patients with acute irreversible pulpitis? Participants will be asked to fill a visual analogue scale to record their pain, after receiving a root canal treatment while using local corticosteroids or not as well as maintaining apical patency or not.

Researchers will compare the use of corticosteroids and maintaining apical patency in reducing post-operative pain.

Inclusion Criteria:

• Symptomatic acute irreversible pulpitis in molar teeth.
• Normal periapical condition including periapical radiography with minimal widening of periodontal ligament.
• Normal probing depth.
• No medical condition.
• No contraindication for administration of corticosteroids and local anesthesia.

Exclusion Criteria:

• Facial or oral paresthesia.
• Pregnancy & breastfeeding.
• Unrestorable tooth.
• Marginal periodontal disease.
• Presence of a crown on the tooth involved.
• Over instrumentation during root canal treatment.
• Long-term use of corticosteroids.
• False-positive cases of sensibility test with necrosis discovered after gaining access to the tooth.
• Cases requiring intrapulpal injection to promote anesthesia.