Efficacy Of Ibuprofen And Dexamethasone For Enhanced Success Of Inferior Alveolar Nerve Block In Irreversible Pulpitis: A Prospective, Randomized Clinical Trial

Symptomatic irreversible pulpitis is a painful condition requiring root canal treatment, often characterized by heightened inflammatory mediator levels like prostaglandins (PGs) and leukotrienes. These mediators reduce the efficacy of local anesthetics, including inferior alveolar nerve block (IANB), by lowering the pain threshold and causing resistance to anesthesia. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and glucocorticoids like dexamethasone have shown promise in improving anesthetic outcomes by suppressing these mediators. Ibuprofen, at higher doses, has been effective in enhancing IANB success, while dexamethasone dual action on the COX and LOX pathways suggests its potential for similar benefits. However, limited research exists on the optimal dosages and combined effects of these drugs in improving anesthesia in cases of irreversible pulpitis. This study aims to evaluate the dose-dependent effects of ibuprofen and dexamethasone, individually and in combination, as oral premedications to enhance IANB success rates. It also seeks to identify the optimal dosages and assess the synergistic effects of these medications compared to a placebo, focusing on improving pain management during endodontic treatment.