Effect of premedication on the success of inferior alveolar nerve block in patients diagnosed with irreversible pulpitis: An umbrella review

Abstract

Successful management of pain during endodontic treatment is essential for both patients and
dentists. Achieving adequate pulp anesthesia in mandibular molars is a significant concern for patients
with irreversible pulpitis during endodontic treatment. The increased sensitization of nociceptors
due to inflammation decreases the success of inferior alveolar nerve block (IANB). The main focus
is on reducing inflammation before delivery of local anesthesia to increase the success of anesthetic
drugs. This umbrella review aimed to revise, qualify and summarize the existing body of evidence
on the effect of premedication on IANB in patients with irreversible pulpitis. A literature search
was conducted using electronic databases (PubMed, Scopus, the Web of Science, and the Cochrane
Library) with no date restriction until September 2021 to identify the relevant studies. All the
cross‑references of the selected studies and grey literature were also screened. Four systematic
reviews assessing the effect of premedication on the success of IANB were selected. A conclusion
was drawn that premedication with >400 mg of ibuprofen can positively affect the success of IANB.
Key Words: Mandibular nerve, pulpitis, systematic review

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Shervin Bagherieh: Pubmed,Google Scholar