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Background <p>Post-endodontic pain is a common complication that negatively impacts patients’ daily lives. Single-dose oral analgesics are often prescribed after non-surgical root canal treatments to manage discomfort; however, their relative efficacy remains unclear. This systematic review and meta-analysis aimed to evaluate the effectiveness of different single-dose postoperative medications for pain relief following root canal treatment (RCT).</p> Methods <p>A comprehensive search of PubMed, Scopus, Embase, and Cochrane CENTRAL up to February 2025 was conducted to identify randomized controlled trials (RCTs) comparing single-dose postoperative analgesics with placebo in patients undergoing non-surgical endodontic treatment. Pain outcomes were assessed using Visual Analog Scales (VAS) at 6–8, 12, and 24&#xa0;h post-treatment. Risk of bias was evaluated using the Cochrane RoB 2 tool. Pairwise and frequentist network meta-analyses were performed, and treatments were ranked using P-scores.</p> Results <p>Ten RCTs were qualitatively analyzed, while five of them were eligible for quantitative analyses and were included in our meta-analysis. They were from four countries with a combined sample size of 347 participants. At 6–8&#xa0;h, Diclofenac + Acetaminophen provided the greatest pain reduction (MD: -6.28, 95% CI: -11.99 to -0.56), followed by Novafen and Ibuprofen + Acetaminophen. At 12 and 24&#xa0;h, Novafen and Naproxen consistently demonstrated superior analgesic effects, whereas Tramadol and Ibuprofen offered moderate relief. Ibuprofen combinations with Acetaminophen or Alprazolam showed variable efficacy. Sensitivity analyses confirmed the robustness of these findings.</p> Conclusions <p>Single-dose oral medications administered after non-surgical root canal treatments effectively reduce post-endodontic pain. Diclofenac + Acetaminophen is most effective for immediate short-term relief, while Novafen and Naproxen provide sustained efficacy at later time points. These results can guide clinicians in selecting optimal single-dose medications for post-RCT pain management. Keywords: postoperative endodontic pain; network meta-analysis; pain management; endodontic treatment </p> Trial registration <p>Not applicable.</p>

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Efficacy and safety of single-dose oral postoperative medications in reducing pain after endodontic treatment: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月26日

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  • Kimia Kelidari,
  • Dorsa Samani

摘要

Background

Post-endodontic pain is a common complication that negatively impacts patients’ daily lives. Single-dose oral analgesics are often prescribed after non-surgical root canal treatments to manage discomfort; however, their relative efficacy remains unclear. This systematic review and meta-analysis aimed to evaluate the effectiveness of different single-dose postoperative medications for pain relief following root canal treatment (RCT).

Methods

A comprehensive search of PubMed, Scopus, Embase, and Cochrane CENTRAL up to February 2025 was conducted to identify randomized controlled trials (RCTs) comparing single-dose postoperative analgesics with placebo in patients undergoing non-surgical endodontic treatment. Pain outcomes were assessed using Visual Analog Scales (VAS) at 6–8, 12, and 24 h post-treatment. Risk of bias was evaluated using the Cochrane RoB 2 tool. Pairwise and frequentist network meta-analyses were performed, and treatments were ranked using P-scores.

Results

Ten RCTs were qualitatively analyzed, while five of them were eligible for quantitative analyses and were included in our meta-analysis. They were from four countries with a combined sample size of 347 participants. At 6–8 h, Diclofenac + Acetaminophen provided the greatest pain reduction (MD: -6.28, 95% CI: -11.99 to -0.56), followed by Novafen and Ibuprofen + Acetaminophen. At 12 and 24 h, Novafen and Naproxen consistently demonstrated superior analgesic effects, whereas Tramadol and Ibuprofen offered moderate relief. Ibuprofen combinations with Acetaminophen or Alprazolam showed variable efficacy. Sensitivity analyses confirmed the robustness of these findings.

Conclusions

Single-dose oral medications administered after non-surgical root canal treatments effectively reduce post-endodontic pain. Diclofenac + Acetaminophen is most effective for immediate short-term relief, while Novafen and Naproxen provide sustained efficacy at later time points. These results can guide clinicians in selecting optimal single-dose medications for post-RCT pain management. Keywords: postoperative endodontic pain; network meta-analysis; pain management; endodontic treatment

Trial registration

Not applicable.