Efficacy of trypsin-chymotrypsin in post-endodontic pain management

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Created On: 16/03/2023

The purpose of a phase IV randomized controlled trial was to assess the effectiveness of trypsin-chymotrypsin in the management of post-endodontic pain following single-visit root canal therapy, its interactions with nonsteroidal anti-inflammatory drugs (NSAIDs), and the occurrence of adverse effects.

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Key take away

In individuals diagnosed with symptomatic irreversible pulpitis, the effectiveness of trypsin-chymotrypsin in post-endodontic pain relief after single-visit treatments is comparable to that of NSAIDs.

Background

Method

Overall, 60 patients with mandibular first molars exhibiting symptomatic irreversible pulpitis were included. Ibuprofen (600 mg), Ambezim-G (Trypsin 5 mg-Chymotrypsin 5 mg), a combination of the two, or a placebo medicine were given postsurgically to the subjects who were randomly assigned to one of four treatment groups (n=15 each). Participants utilized a numerical rating scale (NRS) to rate their level of pain at various time intervals, and clinical safety was determined by passive surveillance of harm.

One-way ANOVA was used to compare ages across groups. The Kruskal-Wallis and Friedman's tests were employed to examine pain scores, and if they were significant, Dunn's test was applied for pair-wise comparisons. The significance level was established at p-value ≤0.05 for the Chi-square test, which was used to compare qualitative data.

Result

There were no statistically significant differences between the Ibuprofen, trypsin-chymotrypsin, and combination groups in terms of how well each intervention reduced postoperative pain. All three groups, however, were very different from the placebo group. The interventions' safety profiles did not differ from one another.

Conclusion

For post-endodontic pain management, the effectiveness of trypsin-chymotrypsin is similar to that of NSAIDs. When administered together, the two have no synergistic effects.