Effect of a Combination of Intranasal Ketorolac and Nitrous Oxide on the Success of the Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis: A Prospective, Randomized, Double-blind Study

Stentz, Daniel S; Drum, Melissa; Reader, Al; Nusstein, John; Fowler, Sara; Beck, Mike

doi:10.1016/j.joen.2017.09.011

Cited by 15 publications

(10 citation statements)

References 26 publications

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“…Apart from oral administration, ketorolac has also been shown to be effective as buccal administration [ 23 ]. In contrast, adjuvant ketorolac with nitrous oxide has not been shown to have any additive analgesic effect in patients with symptomatic pulpitis [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Oral Ketorolac with Inferior Alveolar Nerve Block for Irreversible Pulpitis: A Systematic Review and Meta-analysis

Sivaramakrishnan¹,

Sridharan²

2018

TODENTJ

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Background:Ketorolac has advantages over other analgesics as a pre-anaesthetic medication. Considering this in mind, the present meta-analysis aims to identify the effect of oral ketorolac premedication on the anaesthetic efficacy of Inferior Alveolar Nerve Block (IANB) in patients with irreversible pulpitis.Methods:Full-texts of eligible studies were obtained from electronic databases. The extracted data was analysed using non-Cochrane mode in RevMan 5.0 software. Relative risk [95% CI] was calculated for the success of IANB.Results:Four studies were included for the final review. The success rate of IANB on 221 patients with relative risk of 1.87 [1.36, 2.56] was statistically significant favouring ketorolac. The mean difference for VAS in 171 patients was not statistically significant {-13.55 [-33.91, 6.82]}.Conclusion:Oral ketorolac can be successfully administered as a premedication before conventional inferior alveolar nerve block for endodontic treatment for irreversible pulpitis.

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Section: Discussionmentioning

confidence: 99%

Oral Ketorolac with Inferior Alveolar Nerve Block for Irreversible Pulpitis: A Systematic Review and Meta-analysis

Sivaramakrishnan¹,

Sridharan²

2018

TODENTJ

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“…They selected a concentration of 30%–50% nitrous oxide in their study and reported that concentrations such as 70% would cause more side effects such as nausea and vomiting. Stentz et al [79] administered intranasal ketorolac before nitrous oxide sedation; however, this approach failed to make a significant improvement on IANB and the authors concluded that supplemental anesthesia would still be required.…”

Section: Discussionmentioning

confidence: 99%

Effect of Premedication on the Success of Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis: A Systematic Review of the Literature

Karapinar-Kazandag

Tanalp

Ersev

2019

BioMed Research International

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Background. Failure in the provision of inferior alveolar nerve block anesthesia (IANB) is a significant problem during endodontic treatment of irreversible pulpitis. Various methodologies have been advocated one of which is administration of premedication prior to anesthesia. Despite the considerable number of reports, the topic yet deserves more clarification. This systematic review was conducted to provide an oversight on the effectiveness of premedication prior to IANB in mandibular teeth. Methods. A PubMed and Cochrane Database search was conducted by using MeSH terms inferior alveolar nerve block + pulpitis and mandibular anesthesia+pulpitis. Two reviewers independently performed the screening, selection of papers, and data extraction. Papers in English language that included randomized clinical studies on the impact of different medications on the success of inferior alveolar block anesthesia in irreversible pulpitis were included. Additionally, relevant supporting literature was also used where necessary. Results. Initially, 118 papers were selected from PubMed and 68 were selected from Cochrane. Five additional articles were retrieved from Google Search. Following the elimination of duplicates and irrelevant articles, 35 studies were selected meeting the criteria. It was observed that there was moderate evidence to suggest that some premedications were partially effective for the enhancement of mandibular anesthetic effect in irreversible pulpitis. Conclusion. Though some medications appear to be promising, further supporting research will help highlight this significant topic which requires further clarification.

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“…has shown the effectiveness in the treatment of inflammation in oral cavity and sharp pain, when it was administered orally, buccally, parenterally and intranasally [7][8][9]. However, using the ketorolac trometamine in such dosage form as a dental film will allow providing targeted treatment of the affected areas, as well as to modify release and correct the intensity of the side effects.…”

Section: Development Of Composition and Technologies Of Dental Film Wmentioning

confidence: 99%

Development of Composition and Technologies of Dental Film with Ketorolac Trometamine

et al. 2020

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The report presents the results of the development of dental films with ketorolac trometamine based on the natural biodegradable polymers from the groups of sodium alginates and xanthan gums in combination with lightly crosslinked acrylic polymer carbopol. Physicochemical properties, such as moisture, mucoadhesion, thickness, tensile strength, disintegration in phosphate buffer were determined in obtained samples of this dosage form. A comparison of physicochemical properties of experimental samples and commercial model of dental film has allowed establishing the perspective composition of complex matrix of films with ketorolac trometamine for use in dentistry.

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Effect of a Combination of Intranasal Ketorolac and Nitrous Oxide on the Success of the Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis: A Prospective, Randomized, Double-blind Study

Abstract: Premedication with intranasal ketorolac did not significantly increase the odds of success for the IANB over the use of nitrous oxide/oxygen alone. Supplemental anesthesia will still be needed to achieve adequate anesthesia.

Cited by 15 publications

References 26 publications

Oral Ketorolac with Inferior Alveolar Nerve Block for Irreversible Pulpitis: A Systematic Review and Meta-analysis

Oral Ketorolac with Inferior Alveolar Nerve Block for Irreversible Pulpitis: A Systematic Review and Meta-analysis

Effect of Premedication on the Success of Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis: A Systematic Review of the Literature

Development of Composition and Technologies of Dental Film with Ketorolac Trometamine

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