Clinical Research Directory

Inclusion Criteria: 1. Males or females with age between 18-50 years. 2. Systemically healthy patients (ASA I or II). 3. patient's signs and symptoms give diagnosis of symptomatic irreversible pulpitis in mandibular molar teeth including: i. Presence of sharp pain upon thermal stimulus, lingering pain (often 30 seconds or longer after stimulus removal), spontaneity (unprovoked pain) and referred pain (According to American Association of Endodontics, 2013). According to Azim et al (2022), a clinical diagnosis for symptomatic irreversible pulpitis based on subjective (lingering pain to thermal changes for extended period). ii. Pre-operative sharp pain marked on VAS scale by reading not less than 6. iii. exaggerated response with continuous lingering pain to cold pulp tester using ethyl chloride spray (Walter Ritter Gmbh +Co.-pharmaceutical - Germany. The Egyptian pharmaceutical trading company) and electric pulp tester (Denjoy dental CO., LTD.Changsha.P.R China). iv. Normal periapical radiographic appearance or slight widening of the periodontal ligament space. v.Presence of objective findings such as caries or fracture, deep restorations. vi. No pain on percussion. \- Exclusion Criteria: 1. Allergy to articaine or Ibuprofen 2. History of intolerance to NSAIDs. 3. Patients who have taken analgesics or anti-inflammatory drugs 12 hours before treatment. 4. Patients with two or more adjacent teeth requiring endodontic treatment. 5. Pregnant or nursing females. 6. Teeth that have periodontal affection (with a pocket depth greater than 5mm, associated with swelling or fistulous tract, or greater than grade I mobility) 7. Non-restorable teeth. 8. Teeth fracture and resorption.