title: Efficacy of preoperative ibuprofen and meloxicam on the success rate of inferior alveolar nerve block for teeth with irreversible pulpitis.
abstract: OBJECTIVE
  The purpose of this study was to determine whether premedication with ibuprofen or meloxicam increases the success rate of anaesthesia in teeth with irreversible pulpitis.
  
  
  METHODS
  In this parallel, double-blind clinical trial, 92 patients diagnosed with irreversible pulpitis were randomly divided into four groups of 23 patients. The first group (the no-premedication group) received no premedication, the second group (the meloxicam group) received 7.5 mg of meloxicam, the third group (the ibuprofen group) received 600 mg of ibuprofen, and the fourth group (the placebo group) received placebo 1 hour before intervention. Before taking the medication, electrical pulp testing (EPT) and the Heft-Parker visual analogue scale (VAS) were used to evaluate sensitivity and pain at baseline. Then, local anaesthesia was injected, and after 15 minutes, EPT was used again to evaluate tooth sensitivity. The pain during access preparation was also recorded using the Heft-Parker VAS.
  
  
  RESULTS
  Ninety-two patients were analysed. The success rates of local anaesthesia were 21.7%, 34.8%, 78.3% and 73.9% in the no-premedication, placebo, ibuprofen and meloxicam groups, respectively, according to the EPT values. Considering the Heft-Parker VAS values, no premedication gave a 21.7% success rate, placebo gave a 34.8% success rate, ibuprofen gave an 82.6% success rate and meloxicam gave a 65.2% success rate. The ibuprofen and meloxicam groups showed significantly better results than the placebo and no-premedication groups (P < 0.001). However, the difference between meloxicam and ibuprofen groups was not significant.
  
  
  CONCLUSIONS
  Premedication with meloxicam and ibuprofen significantly increased the success rates of inferior alveolar nerve block anaesthesia for teeth with irreversible pulpitis; however, neither drug provided profound anaesthesia.
authors.affiliation: Endodontic Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Yazdan
authors.initials: Y
authors.lastname: Shantiaee
authors.affiliation: Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sahar
authors.initials: S
authors.lastname: Javaheri
authors.affiliation: Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Movahhedian
authors.affiliation: Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sarah
authors.initials: S
authors.lastname: Eslami
authors.affiliation: Endodontic Department, Iranian Center for Endodontic Research, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Omid
authors.initials: O
authors.lastname: Dianat
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D008297:Male; D008340:Mandibular Nerve; D000077239:Meloxicam; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D011229:Preanesthetic Medication / Q000379:methods*; D011671:Pulpitis / Q000601:surgery*; D012390:Root Canal Therapy / Q000379:methods*; D013843:Thiazines / Q000627:therapeutic use*; D013844:Thiazoles / Q000627:therapeutic use*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D013843:Thiazines; D013844:Thiazoles; D000077239:Meloxicam; D007052:Ibuprofen
keywords: Anaesthetic success; electrical pulp testing; premedication; visual analogue scale