The effect of bromelain-acetaminophen combination on the intensity of endodontic postoperative pain: A randomized clinical trial.

Background: Despite significant advances in dentistry, postendodontic pain is one of the problems that patients still suffer from. This study aimed to evaluate the effect of bromelain-acetaminophen combination on the reduction of postendodontic pain in teeth with symptomatic irreversible pulpitis.

Materials and methods: In this randomized double-blind clinical trial, 60 patients with mandibular first molars with irreversible pulpitis were evaluated. To homogenize the samples, patients who needed endodontic treatment of mandibular first molars with moderate severity were selected according to the American Association of Endodontists case difficulty assessment form. After endodontic treatment, half of the patients were given a placebo and 500 mg acetaminophen every 6 h, and the other half were given 500 mg Anahil capsule and 500 mg acetaminophen every 6 h until the patients' pain was ameliorated. If the patient did not feel pain, they didn't take medication, also we excluded the patients who felt pain for more than 2 days. The Visual Analog Scale (VAS) was used to measure pain before and 6, 12, 24, and 48 h after endodontic treatment. Data were analyzed by SPSS (version 22) software using t-test, Mann-Whitney, and Kaplan-Meyer tests at a 5% error level.

Results: The amount of pain decreased more in the experimental group than in the placebo group 6 and 12 h after endodontic treatment, but by controlling the effect of initial pain (P = 0.627), no significant difference was observed between the two groups in the amount of pain (P = 0.875).

Conclusion: The bromelain-acetaminophen combination did not have an added value when it comes to controlling postendodontic pain.