Comparing Trypsin-Chymotrypsin and Naproxen Sodium for Post-Endodontic Treatment Pain: A Randomised Controlled Trial

J Coll Physicians Surg Pak. 2026 Aug;36(8):985-989. doi: 10.29271/jcpsp.2026.08.985.

ABSTRACT

Objective: To compare the efficacy and mean pain scores of trypsin-chymotrypsin and naproxen sodium for post-endodontic treatment pain.

STUDY DESIGN: A randomised controlled trial. Place and Duration of the Study: Department of Operative Dentistry and Endodontics, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan, from August 2024 to January 2025.

METHODOLOGY: A total of 100 patients were randomly allocated to receive oral formulations of the trypsin-chymotrypsin group (n = 50) or the naproxen sodium group (n = 50). The numeric rating scale (NRS) was utilised to assess pain score at 1, 6, 12, and 24-hour intervals. The Mann-Whitney U test was used for pre- and post-operative comparisons, and age and gender were stratified using the independent-sample t-test and chi-square test.

RESULTS: There was no notable difference between the two groups in baseline characteristics or pre-operative pain (p >0.05). Pain scores were comparable at 1-hour intervals (p = 0.695); however, at 6 hours, the trypsin-chymotrypsin group showed a significant reduction in pain compared with the naproxen sodium group (p = 0.049). At 12- and 24-hour intervals, both groups showed zero pain scores (p = 0.999).

CONCLUSION: The efficacy of trypsin-chymotrypsin was comparable to that of naproxen sodium in reducing post-endodontic pain in teeth with symptomatic irreversible pulpitis.

KEY WORDS: Postoperative pain, Non-steroidal anti-inflammatory agents, Trypsin-chymotrypsin, Root canal therapy, Pain, Numeric rating scale.

PMID:42563331 | DOI:10.29271/jcpsp.2026.08.985