Effect of Preemptive Administration of Ibuprofene-Arginine on Anesthetic Block of the inferior alveolar nerve for Endodontic Treatment of teeth with Symptomatic Pulpitis

Introduction: This study evaluated the effect of premedication with ibuprofen and ibuprofen-arginine, and the influence of preoperative pain and anxiety on inferior alveolar nerve block (IANB) with 2.0% lidocaine in cases of symptomatic irreversible pulpitis (SIP). Methods: 150 patients diagnosed with SIP in the mandibular posterior teeth randomly received ibuprofen (600mg), ibuprofen-arginine (1,155mg), or placebo, 30 minutes before the IANB. The level of preoperative anxiety and pain intensity were assessed using the Modified Dental Anxiety Scale and the Heft-Parker visual scale. The IANB was considered efficient when reporting absence of or mild pain during treatment. The chi-square and z tests were used to evaluate categorical variables. Quantitative variables were evaluated by Analysis of Variance. Differences among the means of the groups were evaluated by Student's test. Variables with non-normal distribution were compared using the Kruskal-Wallis or Mann-Whitney tests. Results: The groups that received ibuprofen and ibuprofen-arginine had significantly higher rates of IANB efficiency, 62% and 78%, respectively, compared with placebo (34%); however, there was no significant difference between the ibuprofen and ibuprofen- arginine groups. Patients who had efficient block in the ibuprofen and ibuprofen-arginine groups had lower median anxiety than those with failed block, 8 versus 15, respectively, and lower mean preoperative pain (118.3). Conclusion: Preemptive ibuprofen-arginine medication increased the efficacy of the IANB; however, there was no significant difference with ibuprofen. The influence exerted by the level of preoperative anxiety and pain intensity should be considered.