Preoperative Acetaminophen- Caffeine- Codeine Combination and Anaesthetic Success in Patients With Acute Pulpitis

After ensuring eligibility, patients will be given premedication 1hr before treatment,which will be done in single visit.

After 1 hour, Pretreatment pain "pain after administration of analgesic or placebo" will be recorded using 0-10 numerical rating scale (NRS) .

Local anesthesia will, then, be done through inferior alveolar nerve block using 1.8 ml Mepivacaine.

The teeth will be isolated using rubber dam and access cavity will be prepared using #2 high-speed round bur.

The patients will be asked to rate their pain on the NRS. The degree of pain during access preparation and/or instrumentation will be recorded.

Success will be defined as no pain or mild pain during endodontic access preparation and/or instrumentation. Any pain more than no pain or mild pain will considered a failure.

The patients will be instructed to return after 2 days to complete the treatment procedures.

Inclusion criteria

• Patients aging between 18-50 years old.
• Patients with mandibular molar with symptomatic irreversible pulpitis.
• Systemically- healthy patients.
• Patients who agree to attend for recall appointments and provide a written consent.

Exclusion criteria

• Pregnant or lactating female patients.
• Patients had allergies to any of test medications.
• Patients had taken analgesics medication within the last 6 hours.
• Moderate or severe marginal periodontitis i.e. pocket probe>3mm.
• Non-restorable teeth, teeth with necrotic pulp, pulp polyp, tooth tender to percussion, root resorption or root canal calcification, periapical disease