A comparative clinical study to evaluate the effectof premedication with Ibuprofen, Tramadol and combination of Ibuprofen and Acetaminophen on success of Inferior Alveolar Nerve Block in patients with Asymptomatic Irreversible Pulpitis.

Prashant Monga,Roopinder Kaur,Pardeep Mahajan,- Vanita Vanita,Shikha Baghi Bhandari,Gurbant Singh

doi:10.3329/bjms.v16i3.32848

Prashant Monga, Roopinder Kaur + Show 4 more

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https://doi.org/10.3329/bjms.v16i3.32848

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Abstract

Introduction: Aim of this study was to evaluate the effective of premedication and to determine the difference between non steroidal anti- inflammatory drugs and centrally acting opioids like tramadol on success rate of inferior alveolar nerve block in patients with asymptomatic irreversible pulpitis.Methods: This double blind clinical study was conducted on 60 patients with asymptomatic irreversible pulpitis in first or second mandibular molar with normal periapical radiographic findings. Three medications i.e., ibuprofen (600mg), tramadol (50 mg) and combination of ibuprofen (400 mg) + acetaminophen (325) were compared and lactose powder capsules were taken as placebo. All patients received IANB and teeth were examined with a cold pulp test using endofrost. Then, endodontic access cavity preparation was initiated. In case of pain during treatment, patients were asked to rate their pain on the visual analog scale.Results: The tramadol group showed significantly higher success rates but ibuprofen and combination of ibuprofen and acetaminophen groups were not significant with placebo (p>05). No Significant differences were there regarding sex of the patients.Conclusion: Premedication with tramadol increased the success rate of IANB.Bangladesh Journal of Medical Science Vol.16(3) 2017 p.370-374

Highlights

Aim of this study was to evaluate the effective of premedication and to determine the difference between non steroidal anti- inflammatory drugs and centrally acting opioids like tramadol on success rate of inferior alveolar nerve block in patients with asymptomatic irreversible pulpitis
Inferior alveolar nerve block (IANB) is effective in anaesthesia of the tooth with normal pulp but this technique fails in majority of cases with inflamed pulp[3,4]
Inferior alveolar nerve block fails in molar having irreversible pulpitis mainly occurs due to inflammation of pulp[5]

Summary

Introduction

Aim of this study was to evaluate the effective of premedication and to determine the difference between non steroidal anti- inflammatory drugs and centrally acting opioids like tramadol on success rate of inferior alveolar nerve block in patients with asymptomatic irreversible pulpitis. Results: The tramadol group showed significantly higher success rates but ibuprofen and combination of ibuprofen and acetaminophen groups were not significant with placebo (p>05). Management of endodontic pain during early phases of endodontic treatment is of paramount importance in reducing fear and anxiety of patient and makes both the dentist and patient confident during the treatment[1] Inferior alveolar nerve block (IANB) is the standardized injection technique for achieving regional anaesthesia for mandibular molar treatment[2]. Inferior alveolar nerve block fails in molar having irreversible pulpitis mainly occurs due to inflammation of pulp[5].

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