Effect of Premedication with Ibuprofen and Dexamethasone on Success Rate of Inferior Alveolar Nerve Block for Teeth with Asymptomatic Irreversible Pulpitis: A Randomized Clinical Trial

Shahi, Shahriar; Mirfazaelian, Hadi; Rahimi, Saeed; Yavari, Hamid Reza; Narimani, Sajjad; Abdolrahimi, Majid; Nezafati, Saeed

doi:10.1016/j.joen.2012.10.011

Cited by 57 publications

(100 citation statements)

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“…The present results are in agreement with those of these earlier reports. Three other investigations, however, have reported that ibuprofen had no significant effect on IANB success rates 1,14,21) . The different inclusion criteria applied in the studies by Aggarwal et al 1) and Oleson et al 14) may account for the discrepancy with the present results.…”

Section: Discussionmentioning

confidence: 90%

“…The contributory effect of premedication with ibuprofen on IANB success rates in treatment of teeth with irreversible pulpitis has been evaluated in several previous studies 1, [13][14][15]21) . The primary function of ibuprofen is blocking the ongoing production of PGs 7) .…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that a single oral dose of dexamethasone is safe and that it has no side effects or contraindications 2) . Shahi et al has reported that premedication with dexamethasone resulted in a success rate of 38.2% in patients with asymptomatic irreversible pulpitis, which was significant in comparison with the control IANB, at only 12.7% 21) . The purpose of this prospective, randomized, double-blind, placebo-controlled study was to compare the efficacy of two different types of anti-inflammatory medication (ibuprofen and dexamethasone) against a placebo in terms of the success rate of IANB during endodontic procedures for irreversible pulpitis in the mandibular molars.…”

Section: Introductionmentioning

confidence: 95%

“…Inferior alveolar nerve block (IANB) is an effective anesthetic technique for management of pain during such procedures in the mandible. The success rate of IANB drastically decreases, however, in patients with irreversible pulpitis 4,11,18,21,26) . Activation of nociceptors by inflammatory mediators such as prostaglandins (PGs) is considered a major cause of this phenomenon 3,6,20,24) .…”

Section: Introductionmentioning

confidence: 99%

“…Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit the chemical inflammatory mediators that activate or sensitize peripheral nociceptors 7) . Investigations into the effect of premedication with NSAIDs on the success rate of IANB have been conducted, but have yielded contradictory results 1,[13][14][15]21) . Glucocorticoids are another class of drugs that prevent the production or release of inflammatory mediators.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Effect of Oral Premedication with Ibuprofen or Dexamethasone on Anesthetic Efficacy of Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis: A Prospective, Randomized, Controlled, Double-blind Study

Bidar

Mortazavi

Forghani

et al. 2017

Bull. Tokyo Dent. Coll.

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The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of preoperative oral administration of ibuprofen or dexamethasone on the success rate of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. Seventy-eight patients with irreversible pulpitis were randomly divided into 3 groups (26 per group) and given one of the following at 1 hr prior to performing local anesthesia: a placebo; 400 mg ibuprofen; or 4 mg dexamethasone. Each patient recorded their pain level on a visual analog scale before taking the medication or placebo, at 15 min after completion of IANB, and during treatment if pain occurred. The success of the anesthesia was defined as no or mild pain at any stage during the endodontic procedure. The success rate of the IANB was 38.5, 73.1, and 80.8% with the placebo, ibuprofen, and dexamethasone, respectively. Both ibuprofen and dexamethasone were significantly more effective than the placebo. No significant difference was observed, however, between the two experimental medications in terms of effectiveness. The results of the present study suggest that premedication with ibuprofen or dexamethasone increases the success rate of an IANB in patients with symptomatic irreversible pulpitis in the mandibular molars.

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