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The effect of premedication with ibuprofen and indomethacin on the success of inferior alveolar nerve block for teeth with irreversible pulpitis.

Author(s): Parirokh M, Ashouri R, Rekabi AR, Nakhaee N, Pardakhti A, Askarifard S, Abbott PV.

Affiliation(s): Oral and Dental Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Publication date & source: 2010, J Endod. , 36(9):1450-4

INTRODUCTION: 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.

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