The Effect of Intra-Canal Ketorolac Application on Post-Endodontic Pain

After obtaining informed consent, the procedure begins with the administration of local anesthesia to ensure patient comfort. A standard approach involves using 2% lidocaine with 1:100,000 epinephrine, delivered either via infiltration for maxillary teeth or mental nerve block for mandibular posterior teeth. Adequate anesthesia is confirmed using a cold test or gentle probing. Once profound anesthesia is achieved, rubber dam isolation is placed to maintain an aseptic field and prevent contamination. The operative field is then disinfected with 5% sodium hypochlorite before proceeding to the access cavity preparation. The access cavity is prepared using a high-speed diamond bur under continuous water coolant. The shape of the access cavity is determined by the tooth's anatomy, ensuring straight-line access to the canal system. Once the pulp chamber is opened, the roof is carefully removed using a round bur or ultrasonic tips, exposing the canal orifices. The chamber is then thoroughly irrigated with 2.5% sodium hypochlorite to remove any residual pulp tissue and debris. A DG16 endodontic explorer is used to locate the canal orifices, after which initial canal exploration is performed using a #10 or #15 K-file to check for patency. Working length determination follows, utilizing an electronic apex locator (EAL) to establish the length of the canal. A confirmation periapical radiograph is taken to verify the readings. To maintain apical patience, a #10 K-file is used in a gentle watch-winding motion until it reaches the apical constriction. The glide path is then established to facilitate subsequent instrumentation. This is achieved by sequentially using hand files (#10, 15, and 20 K-files) with a balanced force technique until a #20 file moves freely to the working length. Throughout this process, frequent irrigation with 2.5% sodium hypochlorite is performed to flush out debris and maintain canal cleanliness. Once the glide path is established, shaping of the cana