Comparison of Premedication Using Ibuprofen and Meloxicam on success rate of Inferior Alveolar Nerve Block in mandibular first molars with symptomatic Irreversible Pulpitis: A double blind Randomized Clinical Trial

Abstract

Introduction: Considering the effects of reducing inflammation and pain in non-steroidal anti-inflammatory drugs in symptomatic irreversible pulpitis, and the fewer side effects of selective cox-2 inhibitors, and the contradictory results of previous studies, this study was conducted. Objective: This study was conducted with the aim of Comparison of Premedication Using Ibuprofen and Meloxicam on success rate of Inferior Alveolar Nerve Block in mandibular first molars with symptomatic Irreversible Pulpitis: A double blind Randomized Clinical Trial Materials and methods: In this randomized double-blind clinical trial, 105 people with mandibular first molars in three pre-medicated groups with ibuprofen (800 mg), meloxicam (15 mg) and placebo (lactose powder) in Tabriz University of Medical Sciences Faculty of Dentistry with the diagnosis of irreversible pulpitis It was evaluated as symptomatic. Patients classified their pain level using the Heft-Parker visual scale before prescribing the drugs. One hour after the oral administration of the capsules, all patients were injected with anesthesia using 1.8 ml of 2% lidocaine and 1:800,000 epinephrine with inferior alveolar nerve block technique. 15 minutes after the injection, the patients were asked about the numbness of their lips, and if there was no numbness of the lips within 15 minutes, the injection was considered unsuccessful and the patient was excluded from the further examination process. The desired tooth was isolated by rubberdam and the access cavity was prepared in them. The patient was instructed to raise his arm in case of pain and enter his pain level on the Heft-Parker visual analog scale. The results were analyzed using SPSS-25 software and Kruskal-Wallis non-parametric tests and Chi-square test. Results: The results of the study showed that there is no significant difference in the amount of pain before giving the drug and after the effect of anesthetic injection in the studied groups (ibuprofen, placebo, meloxicam) (P<0.05). However, a significant difference was observed in the amount of pain during tooth grinding, during entering the pulp chamber and during entering the canal in the studied groups (P < 0.05). So that there was no significant difference in the amount of pain between the ibuprofen and meloxicam groups during tooth grinding, while entering the pulp chamber and while entering the canal (P<0.05), but during tooth grinding, while entering the chamber A significant difference in the pain level was observed between the groups of ibuprofen and meloxicam and placebo during the pulp and entering the canal (P < 0.05). Conclusion: Premedication with ibuprofen and meloxicam significantly increased the anesthetic success of inferior alveolar nerve block (IANB) in mandibular first molars with symptomatic irreversible pulpitis.