The Effect of Three Different Medications on Anesthetic Success and Postoperative Pain

Pain is a very important factor in Endodontic treatment, Both intra- and Post-operatively. In case of symptomatic Irreversible pulpitis, a build up of inflammatory mediators makes it very difficult for the operator to reach the desired level of anesthesia in order to deliver a pain free treatment as well as to eliminate or at least reduce post-operative pain incidence and severity. therefore, a number of pre- medications was suggested with variable success rates. Therefore this trial aims at the use of a new category of anti-inflammatory medications which would be less harmful than the standard NSAIDs or steroids.

Inclusion Criteria: * Patients with symptomatic irreversible pulpitis. * Patients with active pain (moderate-to-severe) in mandibular molars. * Males and females. * Patient with the ability to understand and use pain scales. * Patient who accepts to enroll to the study Exclusion Criteria: * Patients' allergies or any other contraindication to any of the used medications or mepivacaine. * Pregnant and lactating females. * Patients have been taking pain medication 12 hours earlier. * Patient has more than one symptomatic mandibular tooth in the same quadrant. * Patients with periradicular pathosis and/or radiolucency other than widened periodontal ligaments. * Patients with contributory medical history (ASA\>II).