Evaluation Of The Efficacy Of Analgesics In Patients With Symptomatic Apical Periodontitis In Terms Of Number Needed To Treat: A Double Blind Randomized Controlled Trial

Abstract

Aim:
The study aimed to evaluate the efficacy of analgesics in patients with acute apical periodontitis (AAP) using the Number Needed to Treat (NNT) model.

Material and Methods:

Patients diagnosed with AAP without periapical lesions, with or without periodontal ligament (PDL) widening, and those who rated their pain at the 4 cm or above level on the Visual Analogue Scale (VAS) were selected for this study at the dental institute. The patients were randomly divided into four groups, each consisting of 50 individuals.

• Group B received Ibuprofen 400 mg
• Group C received Ketorolac 10 mg
• Group D received Diclofenac Sodium 100 mg
• Group A (Control) received a placebo following the completion of the first dental appointment
  A questionnaire containing the Numerical Rating Scale (NRS) was administered to each patient to record their pain intensity at intervals of 6, 12, 24, 48, and 72 hours after administration of the medication.

Results:
The Kruskal-Wallis test was employed to analyze the data. The NNT values were:

• Group B (Ibuprofen):17
• Group C (Ketorolac) and Group D (Diclofenac Sodium):85 each, both of which were more effective than the control group (Group A).

Conclusion:
Ibuprofen 400 mg had an NNT of 2.17, which was slightly higher than Ketorolac 10 mg and Diclofenac Sodium 100 mg (both with an NNT of 1.85), indicating that both Ketorolac and Diclofenac Sodium were more effective than Ibuprofen. The highest percentage of pain reduction was observed in the Ketorolac and Diclofenac Sodium groups at the 72-hour mark.