Supplementary techniques for pain control during root canal treatment of lower posterior teeth with irreversible pulpitis: A systematic review and meta‐analysis

Abstract

The purpose of this systematic review and meta-analysis was to evaluate utilisation of supplementary techniques for pain control during root canal treatment of lower molars with irreversible pulpitis. The literature was searched using electronic databases up to year 2012. Seventeen studies with 1504 participants were included and each study compared experimental interventions with a standard treatment, i.e. the inferior alveolar nerve block. Changing the injection techniques or supplemental injection had no significant effect on pulp anaesthesia compared to the standard treatment (P = 1.00 or P = 0.14), whereas changing anaesthetic features and increasing anaesthetic volumes resulted in significantly higher rates of anaesthesia than those of the standard treatment (P = 0.03 and P = 0.007, respectively). Premedication with non-steroidal anti-inflammatory drugs (NSAIDs) also significantly increased the success rate of anaesthesia (P = 0.001). Taken together, increased anaesthetic volumes and premedication with NSAIDs provide predictable anaesthesia and more pain control during endodontic treatment of lower molars with irreversible pulpitis.

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

“…, Tupyota et al . ). NSAIDs affect the production of prostaglandins (PGs) and thromboxane A2 responsible for mediating inflammation by reversibly inhibiting cyclooxygenase pathway.…”

“…, Tupyota et al . ) 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.…”

“…, Tupyota et al . ). However, in the absence of comprehensive head‐to‐head comparisons among different NSAIDs and other oral premedications, their relative efficacy is not known.…”

“…Minimizing the failure rate of IANB is important for both patients and clinicians (Walton et al 2008). Supplemental techniques such as intraosseous anaesthesia , buccal infiltration (Aggarwal et al 2009), periodontal ligament injection (Kim 1986) and oral premedication (Lapidus et al 2016, Tupyota et al 2017 have been used to increase the success of anaesthesia for mandibular teeth.…”

What is of interest in Endodontology? A bibliometric review of research published in the International Endodontic Journal and the Journal of Endodontics from 1980 to 2019

“…, Tupyota et al . ) have been published on the topic related to anaesthetic success of inferior alveolar nerve block. Controversially, local anaesthesia studies did not achieve sufficient citations to be included in the list of the top most‐cited 100.…”