Effect of preoperative oral analgesics on pulpal anesthesia in patients with irreversible pulpitis—a systematic review and meta-analysis

Shirvani, Armin; Shamszadeh, Sayna; Eghbal, Mohammad Jafar; Marvasti, Laleh Alim; Asgary, Saeed

doi:10.1007/s00784-016-1974-1

Cited by 34 publications

(30 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…, Shirvani et al . , Tupyota et al . ) reported that oral premedication with NSAIDs increased the success rate of IANB in teeth with irreversible pulpitis.…”

Section: Discussionmentioning

confidence: 99%

“…Achieving successful anaesthesia in mandibular molars diagnosed with irreversible pulpitis is more difficult compared to teeth with normal pulps (Modaresi et al 2006). Previous meta-analyses (Li et al 2012, Lapidus et al 2016, Corbella et al 2017, Shirvani et al 2017, Tupyota et al 2017 reported that oral premedication with NSAIDs increased the success rate of IANB in teeth with irreversible pulpitis. However, the effect of various premedication drugs could not be compared to each other as they were not studied in head-to-head trials.…”

Section: Discussionmentioning

confidence: 99%

“…A variety of pharmacological agents such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids have been investigated as oral premedication to increase the success of anaesthesia in randomized controlled trials (Prasanna et al 2011, Shahi et al 2013, Yadav et al 2015. Previous meta-analyses have shown that the use of oral premedication with NSAIDs increased the success rate of IANB in patients with irreversible pulpitis (Li et al 2012, Lapidus et al 2016, Corbella et al 2017, Shirvani et al 2017, Tupyota et al 2017. However, in the absence of comprehensive head-to-head comparisons among different NSAIDs and other oral premedications, their relative efficacy is not known.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of oral premedication on the anaesthetic efficacy of inferior alveolar nerve block in patients with irreversible pulpitis – A systematic review and network meta‐analysis of randomized controlled trials

et al. 2018

View full text Add to dashboard Cite

This systematic review (SR; PROSPERO database: CRD42017075160) and network meta-analysis (NMA) identified the most effective oral premedication for anaesthetic success of inferior alveolar nerve blocks (IANB) in cases of irreversible pulpitis. Medline and Ebscohost databases were searched up until 10/2017. Randomized controlled trials (RCT) studying the effect of oral premedication, alone or in combination, on the success of IANB for cases of irreversible pulpitis, compared to placebo or other oral premedications, were included. Quality of the included studies was appraised by the revised Cochrane risk of bias tool for randomized trials. Pairwise analysis, NMA and quality of evidence assessment using GRADE criteria were performed. Nineteen studies (n = 1654 participants) were included. NMA demonstrated that compared to placebo, dexamethasone was most effective in increasing anaesthetic success (RR, 2.92 [95% CI 1.74,4.91]; SUCRA = 0.96), followed by NSAIDs (RR, 1.92 [95% CI 1.63,2.27], SUCRA = 0.738) and Tramadol (RR, 2.03 [95% CI 1.18,3.49], SUCRA = 0.737). Premedication with acetaminophen added to NSAIDs demonstrated similar efficacy as NSAIDs alone (RR, 1.06 [95% CI 0.79,1.43]). Sensitivity analyses proved the superiority of dexamethasone or NSAIDs over any other premedications. Subgroup analyses of specific dosages in comparison with placebo demonstrated that dexamethasone 0.5 mg was most effective, followed by ketorolac 10 mg, piroxicam 20 mg, ibuprofen 400 mg + acetaminophen 500 mg and Tramadol 50 mg. Ibuprofen 400 mg, 600 mg and 800 mg had a significantly improved IANB success, while Ibuprofen 300 mg had no effect. Oral premedication with dexamethasone, NSAIDs or Tramadol significantly increased anaesthetic success. More trials are needed to evaluate the premedication effects of dexamethasone or Tramadol for improved anaesthetic success of IANB when treating irreversible pulpitis.

show abstract

“…, Shirvani et al . , Tupyota et al . ) reported that oral premedication with NSAIDs increased the success rate of IANB in teeth with irreversible pulpitis.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of oral premedication on the anaesthetic efficacy of inferior alveolar nerve block in patients with irreversible pulpitis – A systematic review and network meta‐analysis of randomized controlled trials

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Ibuprofen has been used as a preoperative medication, with the goal of decreasing intraoperative narcotics administration and improving postoperative pain control . A single randomized controlled study documents the safety and efficacy of intravenous ibuprofen during pediatric tonsillectomy .…”

Section: Introductionmentioning

confidence: 99%

Safety of preoperative ibuprofen in pediatric tonsillectomy

2018

View full text Add to dashboard Cite

show abstract

“…Patient comfort, cost-saving and rationalization of care time justify the search for an alternative to emergency partial endodontic treatment. A recent systematic review by Shirvani et al [15] showed superior intraoperative analgesia for patients with irreversible pulpitis after administration of preemptive nonsteroidal anti-inflammatory drugs. But, to our knowledge, no clinical trial on the use of orally administered corticosteroid for the treatment of dental pulp inflammation has been conducted.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of orally administered prednisolone versus partial endodontic treatment on pain reduction in emergency care of acute irreversible pulpitis of mandibular molars: study protocol for a randomized controlled trial

Kérourédan

Jallon

Perez

et al. 2017

Trials

View full text Add to dashboard Cite

BackgroundIrreversible pulpitis is a highly painful inflammatory condition of the dental pulp which represents a common dental emergency. Recommended care is partial endodontic treatment. The dental literature reports major difficulties in achieving adequate analgesia to perform this emergency treatment, especially in the case of mandibular molars. In current practice, short-course, orally administered corticotherapy is used for the management of oral pain of inflammatory origin. The efficacy of intraosseous local steroid injections for irreversible pulpitis in mandibular molars has already been demonstrated but resulted in local comorbidities. Oral administration of short-course prednisolone is simple and safe but its efficacy to manage pain caused by irreversible pulpitis has not yet been demonstrated. This trial aims to evaluate the noninferiority of short-course, orally administered corticotherapy versus partial endodontic treatment for the emergency care of irreversible pulpitis in mandibular molars.Methods/designThis study is a noninferiority, open-label, randomized controlled clinical trial conducted at the Bordeaux University Hospital. One hundred and twenty subjects will be randomized in two 1:1 parallel arms: the intervention arm will receive one oral dose of prednisolone (1 mg/kg) during the emergency visit, followed by one morning dose each day for 3 days and the reference arm will receive partial endodontic treatment. Both groups will receive planned complete endodontic treatment 72 h after enrollment. The primary outcome is the proportion of patients with pain intensity below 5 on a Numeric Scale 24 h after the emergency visit. Secondary outcomes include comfort during care, the number of injected anesthetic cartridges when performing complete endodontic treatment, the number of antalgic drugs and the number of patients coming back for consultation after 72 h.DiscussionThis randomized trial will assess the ability of short-term corticotherapy to reduce pain in irreversible pulpitis as a simple and rapid alternative to partial endodontic treatment and to enable planning of endodontic treatment in optimal analgesic conditions.Trial registrationClinicalTrials.gov, identifier: NCT02629042. Registered on 7 December 2015.(Version n°1.1 28 July 2015)Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1883-x) contains supplementary material, which is available to authorized users.

show abstract

Effect of preoperative oral analgesics on pulpal anesthesia in patients with irreversible pulpitis—a systematic review and meta-analysis

Abstract: When compared to placebo, preemptive oral analgesics are superior in achieving anesthetic success in inflamed pulp.

Cited by 34 publications

References 24 publications

Effect of oral premedication on the anaesthetic efficacy of inferior alveolar nerve block in patients with irreversible pulpitis – A systematic review and network meta‐analysis of randomized controlled trials

Effect of oral premedication on the anaesthetic efficacy of inferior alveolar nerve block in patients with irreversible pulpitis – A systematic review and network meta‐analysis of randomized controlled trials

Safety of preoperative ibuprofen in pediatric tonsillectomy

Efficacy of orally administered prednisolone versus partial endodontic treatment on pain reduction in emergency care of acute irreversible pulpitis of mandibular molars: study protocol for a randomized controlled trial

Contact Info

Product

Resources

About