title: The efficacy of pre-operative oral medication of paracetamol, ibuprofen, and aceclofenac on the success of maxillary infiltration anesthesia in patients with irreversible pulpitis: A double-blind, randomized controlled clinical trial.
abstract: OBJECTIVE
  To determine the effect of preoperative administration of paracetamol (PARA), ibuprofen (IBUP), or aceclofenac (ACEC) on the success of maxillary infiltration anesthesia in patients with irreversible pulpitis in a double-blinded randomized controlled trial.
  
  
  METHODS
  One hundred and twenty patients with irreversible pulpitis of a maxillary first molar participated. Patients indicated their pain scores on a Heft Parker visual analog scale, after which they were randomly divided into four groups (n = 30). The subjects received identical capsules containing 1000 mg PARA, 800 mg IBUP, 100 mg ACEC or cellulose powder (placebo, PLAC), 1 h before administration of maxillary infiltration anesthesia with 2% lidocaine containing 1:200,000 epinephrine. Access cavities were then prepared and success of anesthesia was defined as the absence of pain during access preparation and root canal instrumentation. The data were analyzed using chi-squared tests.
  
  
  RESULTS
  The success rates in descending order were 93.3% (IBUP), 90% (ACEC), 73.3% (PARA), and 26.5 % (PLAC). A significant (P < 0.001) difference was found between the drug groups and the PLAC group.
  
  
  CONCLUSIONS
  Pre-operative administration of PARA, IBUP, and ACEC significantly improved the efficacy of maxillary infiltration anesthesia in patients with irreversible pulpitis.
authors.affiliation: Department of Conservative Dentistry and Endodontics, Chettinad Dental College, Rajiv Gandhi Salai, Kelambakkkam, Kanchipuram District, 603103, India.
authors.forename: Anupama
authors.initials: A
authors.lastname: Ramachandran
authors.forename: Sulthan Ibrahim Raja
authors.initials: SI
authors.lastname: Khan
authors.forename: Deepalakshmi
authors.initials: D
authors.lastname: Mohanavelu
authors.forename: Kumarappan Senthil
authors.initials: KS
authors.lastname: Kumar
keywords: Aceclofenac; Paracetamol; ibuprofen; irreversible pulpitis; local anesthesia; maxillary infiltration anesthesia; nonsteroidal antiinflammatory drugs