Efficacy of Ketorolac Buccal Infiltrations and Inferior Alveolar Nerve Blocks in Patients with Irreversible Pulpitis: A Prospective, Double-blind, Randomized Clinical Trial

Akhlaghi, Nahid Mohammadzadeh; Hormozi, Behnoush; Abbott, Paul; Khalilak, Zohreh

doi:10.1016/j.joen.2016.02.003

Cited by 24 publications

(37 citation statements)

References 38 publications

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“…Recently, Praveen et al [ 22 ] conducted a trial comparing ketorolac with prednisolone and the latter drug was observed with more persistent effect than ketorolac and placebo. 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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“…Oral administration of 10-20 mg was used in the studies by Aggarwal et al (5), Jena and Shashirekha (6), Yadav et al (7), and Saha et al (8). A buccal infiltration of ketorolac was used by Aggarwal et al (9) and Akhlaghi et al (10). All of the studies, except the one by Aggarwal et al (5), showed significant increases in success (no or mild pain on access or instrumentation) with the use of ketorolac.…”

Section: Discussionmentioning

confidence: 99%

“…Studies in endodontics have focused on the use of ketorolac for pain reduction (4), using it as an oral premedication (5)(6)(7)(8) or as a buccal infiltration (9,10) to increase the success of the IANB. Although some studies have shown an improved effect (6-10), Aggarwal et al (5) did not.…”

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confidence: 99%

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

Drum

Reader

et al. 2018

Journal of Endodontics

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“…buffering / twin mixing [12][13][14], combination with other supplemental anesthetic techniques [15,16], changing patients' position during injection [17], preceding the injection with oral premedication e.g. ibuprofen / ketorolac / meloxicam / tramadol / dexamethasone [11,[18][19][20][21][22][23][24], and/or following it with cryotherapy application [25]. However, conventional IANB is still associated with a relatively high reported failure rates ranging from 20 to 47% in the premolar area [17,26].…”

Section: Introductionmentioning

confidence: 99%

The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study

2020

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Background: The purpose of this study was to evaluate the anesthetic effectiveness of a buccal infiltration technique combined with local massage (using 2% lidocaine) in the extraction of mandibular premolars to be utilized as an alternative to the conventional inferior alveolar nerve block. Methods: Patients eligible included any subject with a clinical indication for tooth extraction of the mandibular 1st or 2nd premolars. All patients were anesthetized buccally by local infiltration technique followed by an external pressure applied for 1 min directly over the injection area. In each case, another local injection was given lingually. All operations were started at approximately 5 min after the buccal injection. The collected data included age, gender, pain perception and its intensity during treatment at three checkpoints, apical tenderness, and the type of extraction. Any associated complications or difficulties were also recorded. Then the results were analyzed and interpreted using appropriate statistical tests. The significance level was set at P ≤ 0.05. Results: A total of 247 cases (1st premolar, n = 119; 2nd premolar, n = 128), predominantly male, were included. In 95% of study sample, the patients were satisfied with the dental extraction without any pain. However, in 5% of cases, pain was reported at the stage of tooth removal. Apical tenderness was found to be present in 11% of the total cases. Three teeth required surgical removal. Upon analysis, no significant differences in the success rates were detected between the 2 premolar groups or amongst the various age groups. Minor and transient side effects were reported in this study. Conclusion: The technique is simple and effective as well. It might be considered as an alternative anesthetic injection to the inferior alveolar nerve block for dental extraction of the mandibular premolars.

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Efficacy of Ketorolac Buccal Infiltrations and Inferior Alveolar Nerve Blocks in Patients with Irreversible Pulpitis: A Prospective, Double-blind, Randomized Clinical Trial

Cited by 24 publications

References 38 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 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

The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study

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