- To evaluate the effect of preoperative oral ibuprofen (IBU) on the success of inferior alveolar nerve blocks (IANBs) with mepivacaine containing 1 : 100 000 epinephrine for patients with symptomatic irreversible pulpitis (SIP).
- N= 50 (2 groups)
- Exclusion criteria: Pregnant patients, allergy to NSAIDs or mepivacaine, altered sensation syndromes or history of previous sensation alteration, ingestion of food 1 h before the study, poor tooth integrity for rehabilitation and illegal drug ingestion.
- Inclusion criteria: >18 years, good health, no intake of medicaments for 12 h prior to treatment, SIP of mand posterior tooth. Prolonged moderated to severe pain (>10 s) according to Heft-Parker scale.
- Positive/negative control: Gelatin administration
- Control & Design: Double blind RCT. Patients assigned sequential numbers in order of enrollment and assigned according to randomization table. Patients received identical capsules w/either 600mg ibuprofen or gelatin 1 hour prior to administration of IANB w/2% Mepivacaine w/1:100k Epi. After 15 minutes, three-step exam done to evaluate lip numbness, cold testing, and discomfort during endo access. One blinded administrator conducted diagnosis/injection. Another independent investigator evaluated effects of treatment.
- Criteria of evaluation: Absence of pain during exam and procedure
- After IANB, all patient reported lip numbness
- IANB success rates for Ibuprofen group were 72%, for the placebo group 36%
- At 24 hrs, 4 patients reported moderate-severe pain (1 IBU, 3 PLA)
- At 48 hrs, no patients reported pain.
Preoperative oral administration of IBU 1 hour prior could improve the efficacy of mepivacaine IANB in patients with symptomatic irreversible pulpitis.