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RecruitingNCT07400471Updated Feb 11, 2026

The Effects of Preemptive Multimodal Analgesic on Endodontic Pain Following Root Canal Therapy.

An Early Phase 1 interventional study of Pregabalin- Acetaminophen and Duloxetine- Acetaminophen in Post Endodontic Pain, Mechanical Detection Threshold and Mechanical Pain Threshold, sponsored by Chattogram International Dental College. Recruiting at 1 site in Bangladesh. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-02-11.

Sponsored by Chattogram International Dental College · Early Phase 1, Interventional, and Treatment

Phase
Early Phase 1
Study type
Interventional
Enrollment
280
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

A clinical trial comparing preemptive multimodal analgesics with placebo in the management of immediate and chronic post-endodontic pain. The study utilizes statistical methods such as chi-squared, T-tests, and regression analysis, accounting for multiple outcomes with the Bonferroni adjustment. Duloxetine hydrochloride and pregabalin, both available in Bangladesh, are evaluated as experimental drugs, while placebos are used to assess psychological effects on pain. All participants receive standard interventional treatments, with acetaminophen provided as needed, and ethical considerations are addressed according to international guidelines.

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Conditions studied

  • Post Endodontic Pain
  • Mechanical Detection Threshold
  • Mechanical Pain Threshold
  • Mechanical Pain Sensitivity

Keywords

  • post endodontic pain
  • Root canal Therapy
  • Multimodal Analgesia
  • Dynamic sensory test
03

In context

Lead sponsor

This is the only study on the registry with Chattogram International Dental College as lead sponsor.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  1. Patient's aged 18 years more.
  2. ASA physical status I-II.
  3. Patient with the complain of pain originated from teeth and surrounding structure.
  4. Preoperative pain severity is moderate to severe.
  5. Patient can be able to make communication about their pain.
  6. Patients give consent to attain this research.
  7. Patients have others concomitant chronic pain.
  8. Patients who will have non-surgical endodontic treatment.
  9. Patients who will have non-surgical endodontic retreatment.
  10. Patients who will have surgical endodontic treatment.

Exclusion criteria

Exclusion Criteria:

  1. Patient would not like to attain in research.
  2. Patients have any medical condition those are contra indication for study drug.
  3. ASA physical status III, IV, V.
  4. Patient already under treated any anti convulsent drug.
  5. Patient participant in other clinical trials.
  6. Lack of motivation or poor adharence to study protocols.
  7. Patient with Pregnancy
  8. Severe organ dysfunction
  9. Patient have Hepatitis B, and other cross infection disease like (HIV)
  10. Uncontrolled comorbidities that patient do not fit for endodontic treatment.
  11. Severe cognitive impaired patients.
  12. History of certain cancers or severe hematological issues.
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Study design

Phase
Early Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Outcomes assessor)
Enrollment
280 participants (estimated)

Study arms

  • Active comparator
    Multimodal Analgesia

    Preemptive Multi modal analgesic drug: Experimental group will be divided into 2 subgroups according to use of drug. A. Pregabalin-acetaminophen. B. Duloxetine-Acetaminophen Pregabalin-acetaminophen: Before a half-hour endodontic treatment, patients in this group will receive a single dosage of 50 mg pregabalin and 500 mg acetaminophen. If necessary, acetaminophen dosages of 500 mg will be administered three times a day. Duloxetine-Acetaminophen: Prior to a half-hour endodontic treatment, patients in this group will receive a single dosage of 500 mg of acetaminophen and 30 mg of Duloxetine. If necessary, acetaminophen dosages of 500 mg will be administered three times a day.

    Drug: Pregabalin- Acetaminophen · Drug: Duloxetine- Acetaminophen

  • Placebo comparator
    Control

    Placebo: Patient in this group will receive placebo drug before half an hour of operating procedure. If necessary, acetaminophen dosages of 500 mg will be administered three times a day and noted

    Drug: Pregabalin- Acetaminophen · Drug: Duloxetine- Acetaminophen

Interventions

  • DrugPregabalin- Acetaminophen

    Preemptive Multi modal analgesic drug: Experimental group will be divided into 2 subgroups according to use of drug. A. Pregabalin-acetaminophen. B. Duloxetine-Acetaminophen Pregabalin-acetaminophen: Before a half-hour endodontic treatment, patients in this group will receive a single dosage of 50 mg pregabalin and 500 mg acetaminophen. If necessary, acetaminophen dosages of 500 mg will be administered three times a day.

  • DrugDuloxetine- Acetaminophen

    Duloxetine-Acetaminophen: Prior to a half-hour endodontic treatment, patients in this group will receive a single dosage of 500 mg of acetaminophen and 30 mg of Duloxetine. If necessary, acetaminophen dosages of 500 mg will be administered three times a day.

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What researchers measure

Primary outcomes

  1. Effects of Preemptive multimodal analgesia on post endodontic pain

    Primary Pain during endodontic treatment and the effectiveness of intervention will be evaluated at 6, 12, 24, 48, 72, and hourly intervals after the endodontic procedure. Treatment-related anaesthetic efficacy will be assessed using the VAS (Visual Analogue Scale; numerical value 0-10). During endodontic treatment, the level of pain will decide how effective the anesthetic is. The patient will be asked to rate the analgesic effects on a VAS (Visual Analogue Scale) scale by providing a numerical number 0-10. '0" are indicated no pain, 1-3= mild pain, 4-6= moderate pain, 7-10= sever pain.

    Time frame: 6, 12, 24, 48, 72 hours

Secondary outcomes

  1. Mechanical Detection Threshold

    Mechanical Detection Threshold: A standardized set of modified von Frey hairs (Opti-hair2-Set, Marstock Nervtest, Germany) that exert stresses upon bending between 0.25 and 512 mN graded by a factor of 2 (1-2 s contact time) were used to determine the mechanical detection threshold (MDT). With a rounded tip and 0.5 mm in diameter, the von Frey hairs' contact area with the skin was consistent in size and shape to prevent sharp edges that could aid in nociceptor activation. Five threshold determinations with a sequence of increasing and decreasing stimulus intensities were made using the "method of limits." The geometric mean of these five series served as the final threshold.

    Time frame: baseline, 72 hours

  2. Mechanical Pain Threshold

    Mechanical Pain Threshold: A set of seven pin-prick mechanical stimulators with preset stimulus intensities (flat contact area of 0.2 mm diameter) that applied forces of 8, 16, 32, 64, 128, 256, and 512 mN were used to test the mechanical pain threshold (MPT). These stimuli were custom-made and weighted. Until the first perception of sharpness was attained, the stimulators were applied in ascending order at a pace of two seconds on, two seconds off. The geometric mean of five sequences of rising and descending stimuli served as the final threshold. The purpose of this test was to identify pinprick hypoalgesia. Before initiation of endodontic treatment, the patient has to take drug that's are supplied in enveloped.

    Time frame: baseline, 72 hours

  3. Mechanical Pain Sensitivity

    Mechanical Pain Sensitivity will test using the same weighted pinprick stimuli as for mechanical pain threshold. To obtain a stimulus- response- function, these seven pinprick stimuli will apply in a balanced order, five times each, and patient will ask to give a pain rating for each stimulus on a 0-10 VAS scale ( '0' indicate no pain; 10 indicate most intense pain imaginable.

    Time frame: baseline, 72 hours

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Study locations

1 of 1 sites recruiting
  • Professor. Dr. Md. Abu Saeed Ibn Harun
    Chittagong, Chattogram 4212, Bangladesh
    Recruiting
08

References and documents

Publications

  • Anibal Diogenes, Michael A. Henry. Pain Pathways and Mechanisms of the Pulpodentin Complex. Chapter 8; Seltzer and Bender's Dental Pulp. 2nd edition. Quintessence Publishing Co Inc;2012.
  • Jang YE, Kim Y, Kim BS. Influence of Preoperative Mechanical Allodynia on Predicting Postoperative Pain after Root Canal Treatment: A Prospective Clinical Study. J Endod. 2021 May;47(5):770-778.e1. doi: 10.1016/j.joen.2021.01.004. Epub 2021 Jan 29. PubMed 33516824 ↗
  • Alelyani AA, Azar PS, Khan AA, Chrepa V, Diogenes A. Quantitative Assessment of Mechanical Allodynia and Central Sensitization in Endodontic Patients. J Endod. 2020 Dec;46(12):1841-1848. doi: 10.1016/j.joen.2020.09.006. Epub 2020 Sep 15. PubMed 32941893 ↗
  • Wiech K, Ploner M, Tracey I. Neurocognitive aspects of pain perception. Trends Cogn Sci. 2008 Aug;12(8):306-13. doi: 10.1016/j.tics.2008.05.005. Epub 2008 Jul 5. PubMed 18606561 ↗
  • Md. Abu Saeed Ibn Harun et al. The dimension and severity of orofacial pain in patients with current and chronic odontogenic pain. M Dent J 2021; 41(3): 235-244.
  • Woolf CJ. Windup and central sensitization are not equivalent. Pain. 1996 Aug;66(2-3):105-8. No abstract available. PubMed 8880830 ↗
  • Md. Abu Saeed Ibn Harun et al. Endogenous Pain modulation of Irreversible Pulpitis and Persistent Endodontic Pain. Chattagram International Dental College Journal 2019; 2(1):9-13.
  • O'Keefe EM. Pain in endodontic therapy: preliminary study. J Endod. 1976 Oct;2(10):315-9. doi: 10.1016/S0099-2399(76)80047-7. No abstract available. PubMed 1068208 ↗
  • Doleman B, Leonardi-Bee J, Heinink TP, Boyd-Carson H, Carrick L, Mandalia R, Lund JN, Williams JP. Pre-emptive and preventive NSAIDs for postoperative pain in adults undergoing all types of surgery. Cochrane Database Syst Rev. 2021 Jun 14;6(6):CD012978. doi: 10.1002/14651858.CD012978.pub2. PubMed 34125958 ↗
  • Price DD, Finniss DG, Benedetti F. A comprehensive review of the placebo effect: recent advances and current thought. Annu Rev Psychol. 2008;59:565-90. doi: 10.1146/annurev.psych.59.113006.095941. PubMed 17550344 ↗
  • Ince B, Ercan E, Dalli M, Dulgergil CT, Zorba YO, Colak H. Incidence of postoperative pain after single- and multi-visit endodontic treatment in teeth with vital and non-vital pulp. Eur J Dent. 2009 Oct;3(4):273-9. PubMed 19826598 ↗
  • Al-Nahlawi T, Alabdullah A, Othman A, Sukkar R, Doumani M. Postendodontic pain in asymptomatic necrotic teeth prepared with different rotary instrumentation techniques. J Family Med Prim Care. 2020 Jul 30;9(7):3474-3479. doi: 10.4103/jfmpc.jfmpc_342_20. eCollection 2020 Jul. PubMed 33102316 ↗
  • Nixdorf DR, Moana-Filho EJ, Law AS, McGuire LA, Hodges JS, John MT. Frequency of persistent tooth pain after root canal therapy: a systematic review and meta-analysis. J Endod. 2010 Feb;36(2):224-30. doi: 10.1016/j.joen.2009.11.007. PubMed 20113779 ↗
  • Oshima K, Ishii T, Ogura Y, Aoyama Y, Katsuumi I. Clinical investigation of patients who develop neuropathic tooth pain after endodontic procedures. J Endod. 2009 Jul;35(7):958-61. doi: 10.1016/j.joen.2009.04.017. PubMed 19567314 ↗
  • Hargreaves KM, BermanLH, Cohen S. Cohen's Pathways of the Pulp. 11th ed. Amsterdam, Netherlands: Elsevier; 2015.
  • Santos-Puerta N, Penacoba-Puente C. Pain and Avoidance during and after Endodontic Therapy: The Role of Pain Anticipation and Self-Efficacy. Int J Environ Res Public Health. 2022 Jan 27;19(3):1399. doi: 10.3390/ijerph19031399. PubMed 35162422 ↗
  • Smith EA, Marshall JG, Selph SS, Barker DR, Sedgley CM. Nonsteroidal Anti-inflammatory Drugs for Managing Postoperative Endodontic Pain in Patients Who Present with Preoperative Pain: A Systematic Review and Meta-analysis. J Endod. 2017 Jan;43(1):7-15. doi: 10.1016/j.joen.2016.09.010. Epub 2016 Dec 6. PubMed 27939729 ↗
  • Suneelkumar C, Subha A, Gogala D. Effect of Preoperative Corticosteroids in Patients with Symptomatic Pulpitis on Postoperative Pain after Single-visit Root Canal Treatment: A Systematic Review and Meta-analysis. J Endod. 2018 Sep;44(9):1347-1354. doi: 10.1016/j.joen.2018.05.015. Epub 2018 Jul 24. PubMed 30054100 ↗
  • Zanjir M, Sgro A, Lighvan NL, Yarascavitch C, Shah PS, da Costa BR, Azarpazhooh A. Efficacy and Safety of Postoperative Medications in Reducing Pain after Nonsurgical Endodontic Treatment: A Systematic Review and Network Meta-analysis. J Endod. 2020 Oct;46(10):1387-1402.e4. doi: 10.1016/j.joen.2020.07.002. Epub 2020 Jul 12. PubMed 32668310 ↗
  • Mazaleuskaya LL, Theken KN, Gong L, Thorn CF, FitzGerald GA, Altman RB, Klein TE. PharmGKB summary: ibuprofen pathways. Pharmacogenet Genomics. 2015 Feb;25(2):96-106. doi: 10.1097/FPC.0000000000000113. No abstract available. PubMed 25502615 ↗
  • Compound Summery Acetaminophen. National Library of Medicine. Seen 2023. www.pubchem.ncbi.nlm.nih.gov.
  • Park SJ, Zhang S, Chiang CY, Hu JW, Dostrovsky JO, Sessle BJ. Central sensitization induced in thalamic nociceptive neurons by tooth pulp stimulation is dependent on the functional integrity of trigeminal brainstem subnucleus caudalis but not subnucleus oralis. Brain Res. 2006 Sep 27;1112(1):134-45. doi: 10.1016/j.brainres.2006.06.115. Epub 2006 Aug 22. PubMed 16930568 ↗
  • 37. Harun, A. S. I. harun, Hossain, . A., Jabber, S. and Hasan, H. . (2021) "The dimension and severity of orofacial pain in patients with current and chronic odontogenic pain", Mahidol Dental Journal. Bangkok, Thailand, 41(3), pp. 235-244. available at: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/251124 (accessed: 3 June 2025).

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 11, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07400471
Lead sponsor
Chattogram International Dental College
Responsible party
Prof. Dr. Md. Abu Saeed Ibn Harun (Professor, Chattogram International Dental College) — Principal investigator
First posted
Feb 10, 2026
Start date
Feb 6, 2026 (estimated)
Primary completion
Mar 30, 2027 (estimated)
Completion
Apr 30, 2027 (estimated)
Last update
Feb 11, 2026

Study contacts

Prof.Dr. Md. Abu Saeed Ibn Harun, MS
Contact
dr.abusaeed@cidch.edu.bd
8801711157586

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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