Effect of Genetic Polymorphisms on Response to Preoperative NSAIDs in Endodontic Postoperative Pain Management

Inclusion Criteria: 1. Patients aged between 18 and 65 years 2. Vital mandibular molar teeth diagnosed with symptomatic apical periodontitis 3. ASA physical status classification I or II 4. Preoperative VAS pain score greater than 50 5. No known genetic disorders (e.g., Down syndrome, congenital insensitivity to pain) Exclusion Criteria: 1. Patients classified as ASA III or higher 2. Pregnant women or those suspected of being pregnant 3. Presence of root canal curvature greater than 25° (Schilder classification) 4. Patients with generalized periodontitis 5. Presence of periodontal pockets deeper than 3 mm in the affected tooth 6. History of systemic disease or known allergies 7. Patients with diagnosed psychiatric or psychological disorders 8. Presence of swelling, sinus tract, or preoperative tenderness on palpation 9. Patients with bruxism 10. Presence of resorption in the affected tooth 11. Use of analgesic or anti-inflammatory drugs within 12 hours prior to the procedure 12. Teeth with root fractures, ankylosis, or pathological mobility