Abstract
Introduction
This randomized double-blinded trial aimed to compare the anesthetic success of inferior
alveolar nerve blocks (IANBs) with 2% lidocaine in mandibular molars with symptomatic
irreversible pulpitis (SIP) after oral premedication of prednisolone, dexamethasone,
and ketorolac with placebo.
Methods
One hundred eighty-four patients diagnosed with SIP in mandibular molars randomly
received prednisolone, dexamethasone, ketorolac, or placebo (n = 46 each) 60 minutes before the administration of an IANB. The access cavity preparation
was initiated after successfully confirming lip numbness and two consecutive negative
responses to electric pulp testing. The success of the anesthesia was clinically confirmed
when pain was absent during the endodontic access or instrumentation. A one-way analysis
of variance test was used to compare quantitative variables among the groups, and
chi-square tests were used for comparing categorical variables. Binary logistic regression
was performed to analyze the relationship of age, preoperative pain, and preoperative
medications.
Results
When premedicated with oral dexamethasone, ketorolac, prednisolone, and placebo, the
success rate of IANB was determined to be 60.86 %, 65.21 %, 56.52 %, and 21.73 %,
respectively. Compared to the placebo, the success rate of IANB was significantly
increased when patients were premedicated with prednisolone, dexamethasone, or ketorolac.
However, there were no statistically significant differences among prednisolone, dexamethasone,
and ketorolac. One individual in the ketorolac group reported gastritis, whereas no
adverse effects were reported in the dexamethasone or prednisolone groups.
Conclusions
Preoperative use of oral ketorolac, dexamethasone, or prednisolone may increase the
anesthetic efficacy of IANB in mandibular molars with SIP.
Key Words
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Article info
Publication history
Published online: January 31, 2023
Identification
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© 2023 American Association of Endodontists.
