The effect of premedication with ibuprofen and indomethacin on the success of inferior alveolar nerve block for teeth with irreversible pulpitis.
BACKGROUND
Achieving pulp anesthesia with irreversible pulpitis is difficult. This study evaluated whether nonsteroidal anti-inflammatory drugs assist local anesthesia.


METHODS
In a randomized double-blinded clinical trial, 150 patients (50 per group) with irreversible pulpitis were given placebo, 600 mg ibuprofen, or 75 mg indomethacin 1 hour before local anesthesia. Each patient recorded their pain score on a visual analog scale before taking the medication, 15 minutes after anesthesia in response to a cold test, during access cavity preparation and during root canal instrumentation. No or mild pain at any stage was considered a success. Data were analyzed by the chi-square and analysis of variance tests.


RESULTS
Overall success rates for placebo, ibuprofen, and indomethacin were 32%, 78%, and 62%, respectively (p < 0.001). Ibuprofen and indomethacin were significantly better than placebo (p < 0.01). There was no difference between ibuprofen and indomethacin (p = 0.24).


CONCLUSIONS
Premedication with ibuprofen and indomethacin significantly increased the success rates of inferior alveolar nerve block anesthesia for teeth with irreversible pulpitis.
Parirokh
Masoud
M
Oral and Dental Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Ashouri
Rezvan
R
Rekabi
Ali Reza
AR
Nakhaee
Nouzar
N
Pardakhti
Abbas
A
Askarifard
Sara
S
Abbott
Paul V
PV
D000328:Adult; D000704:Analysis of Variance; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D007213:Indomethacin / Q000627:therapeutic use*; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008334:Mandible; D008340:Mandibular Nerve / Q000187:drug effects; D008963:Molar; D009407:Nerve Block / Q000379:methods; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D011229:Preanesthetic Medication / Q000379:methods; D011292:Premedication / Q000379:methods*; D011446:Prospective Studies; D011671:Pulpitis / Q000150:complications / Q000601:surgery*; D012390:Root Canal Therapy / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D008012:Lidocaine; D007052:Ibuprofen; D007213:Indomethacin