Preoperative Intraligamentary Injection of Dexamethasone Can Improve the Anesthetic Success Rate of 2% Lidocaine during the Endodontic Management of Mandibular Molars with Symptomatic Irreversible Pulpitis

Aggarwal, Vivek; Singla, Mamta; Saatchi, Masoud; Gupta, Alpa; Hasija, Mukesh; Meena, Babita; Kumar, Umesh

doi:10.1016/j.joen.2020.11.023

Cited by 11 publications

(24 citation statements)

References 36 publications

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“…In total, 17 clinical assays were found in both databases ( Figure 1 ), of which 14 obtained a low or medium risk-of-bias result according to the Cochrane Collaboration’s risk-of-bias tool ( Figure 2 ). In this way, 14 clinical trials [ 8 , 9 , 10 , 11 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ] were used to perform the qualitative analysis, and 11 were used for the quantitative assessment [ 8 , 9 , 11 , 14 , 15 , 16 , 17 , 20 , 21 , 22 , 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…Accordingly, various drugs that interfere with or reduce inflammation and/or pain—such as the supplementary administration of local anesthetics [ 3 ], as well as the systemic administration of nonsteroidal anti-inflammatory drugs (NSAIDs) [ 3 ], corticosteroids [ 7 ], and opioid analgesics [ 8 , 9 , 10 , 11 ]—have been used to relieve pain and reduce inflammation of the pulp tissue, and thus achieve the most adequate dental anesthesia during endodontic treatment [ 3 , 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some clinical assays have been carried out to determine the effect of dexamethasone on the success of dental anesthesia in patients with SIP, and interesting results have been found [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. The main aim of this systematic review and meta-analytical assessment was to evaluate the effects of the systemic and local administration of dexamethasone on the anesthetic success rate, pain intensity, and adverse effects in patients with SIP.…”

Section: Introductionmentioning

confidence: 99%

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Dexamethasone Increases the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis

et al. 2022

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Inferior alveolar nerve block (IANB) has a high failure rate in subjects with symptomatic irreversible pulpitis (SIP). It has been suggested that drugs with anti-inflammatory activity could improve the efficacy of the anesthetic used for IANB. The aim of this study was to assess the effect of dexamethasone on the success of dental anesthesia in patients with SIP. An information search was performed using PubMed and Google Scholar. The risk of bias of the included studies was evaluated with the Cochrane Collaboration’s risk-of-bias tool. The anesthetic success rate, pain intensity (VAS), and adverse effects were extracted. Data were analyzed using the Mantel–Haenszel test and odds ratio or the inverse variance and standardized mean difference. Dexamethasone increased the anesthetic success in comparison with placebo (n = 502; p < 0.001; OR = 2.59; 95% CIs: 1.46 to 4.59). Moreover, patients who were given dexamethasone had lower pain scores at 6 h (n = 302; p < 0.001; MD= −1.43; 95% CIs: −2.28 to −0.58), 12 h (n = 302; p < 0.0001; MD = −1.65; 95% CIs: −2.39 to −0.92), and 24 h (n = 302; p < 0.0008; MD = −1.27; 95% CIs: −2.01 to −0.53) when compared with placebo. In conclusion, the systemic administration of dexamethasone increases the anesthetic success rate and improves pain management in patients with SIP.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dexamethasone Increases the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis

et al. 2022

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“…The types of VAS used in different studies may have affected this result. While Pedro-Muñoz and Mena-Álvarez (2017) used the 100 mm VAS, 170 mm HP VAS, which was used in the present study, is frequently used in measuring pre-operative and intraoperative pain levels in patients with SIP (Aggarwal et al, 2021;Yadav et al, 2015). Although tramadol was used at the same dose as used by Aksoy and Ege (2020a), a higher success rate was found in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…The number of studies on the effect of dexamethasone on IANB anaesthesia success rates is limited. Aggarwal et al (2021) reported an anaesthesia success rate of 73% with intraligamentary dexamethasone injection applied in addition to standard IANBs using lidocaine in mandibular molars with SIP. Bidar et al (2017) registered a success rate of 80.8% using a pre-operative oral dose of 4 mg dexamethasone, which increased the pulpal anaesthesia success rate significantly in comparison to the control group.…”

Section: Discussionmentioning

confidence: 99%

The effect of pre‐operative submucosal administration of dexamethasone, tramadol, articaine on the success rate of inferior alveolar nerve block on mandibular molars with symptomatic irreversible pulpitis: A randomized, double‐blind placebo‐controlled clinical trial

2021

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Aim: To establish the effects of submucosal tramadol, dexamethasone and articaine on the success of inferior alveolar nerve blocks (IANB) during root canal treatment of mandibular molars with symptomatic irreversible pulpitis (SIP). Methodology:In this randomized double-blind, controlled clinical trial, 120 patients with the diagnosis of SIP in their mandibular first or second molars were included and randomly divided into four groups (n = 30). The control group received normal saline and three experimental groups received a single dose of dexamethasone (8 mg/2 mL), or tramadol (100 mg/2 mL) or articaine (4% / 2 mL). The pre-operative pain levels of the patients were measured with the Heft-Parker visual analogue scale (HP VAS). All patients received standard IANB of 4% articaine with 1:200000 epinephrine. Following the observation of lip numbness, submucosal injections were administered into the mucobuccal fold adjacent to the mandibular molars. After 15 min, standard root canal treatment was initiated, and the pain intensity levels recorded from the access cavity preparation to pulp extirpation were measured with HP VAS. The duration of the anaesthesia was also evaluated. The experimental groups were compared using one-way ANOVA or Kruskal-Wallis H-test. The groups that were significantly different were compared pairwise using the Tukey Multiple Comparison test. The Chi-square test was used to compare the categorical variables. Results:The submucosal administration of articaine significantly increased the success rate to 63% in comparison with the control group that received submucosal saline (p < .05). The success rate of pulpal anaesthesia was 37% in the control group, 57% in the tramadol group and 47% in the dexamethasone group, with no significant difference in the success rate among these groups. In the dexamethasone group, the duration of the anaesthetic effect of IANB was significantly longer than those in the other groups (p < .001). Conclusions:In patients with SIP, pre-operative submucosal administration of articaine increased the success rate of IANB, while administration of dexamethasone | 1983 AKSOY ET AL.

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Insights Into the February 2021 Issue of the JOE

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Diogenes

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Journal of Endodontics

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Preoperative Intraligamentary Injection of Dexamethasone Can Improve the Anesthetic Success Rate of 2% Lidocaine during the Endodontic Management of Mandibular Molars with Symptomatic Irreversible Pulpitis

Cited by 11 publications

References 36 publications

Dexamethasone Increases the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis

Dexamethasone Increases the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis

The effect of pre‐operative submucosal administration of dexamethasone, tramadol, articaine on the success rate of inferior alveolar nerve block on mandibular molars with symptomatic irreversible pulpitis: A randomized, double‐blind placebo‐controlled clinical trial

Insights Into the February 2021 Issue of the JOE

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