Effectiveness of oral premedication on anesthetic success of Inferior alveolar nerve block in mandibular molars with symptomatic irreversible pulpitis using Dexamethasone and combination of Dexamethasone and Ibuprofen A double blinded randomized controlled trial

An Inferior Alveolar Nerve Block (IANB)is the standardized injection technique for mandibular molar teeth. However, IANB does not always result in successful pulpal anesthesia, especially in patients with Symptomatic irreversible pulpitis. The fact that patients often feel pain during endodontic treatment of teeth with Symptomatic irreversible pulpitis is a challenge for the clinician. Successful anesthesia is only achieved if no or minimal pain is achieved during access cavity preparation and canal shaping. Pain during access opening and instrumentation caused by anesthetic failure was even recorded in patients who had demonstrated positive signs of anesthesia such as numbness in the lower lip and the tip of the tongue. Thus, lip numbness was shown not to be always related to successful pulpal anesthesia. The Successful management of pain during root canal treatment is important for both patients and dentist.

Various Studies have shown that the success rate of anesthesia for pain -free endodontic access and instrumentation in teeth with irreversible pulpitis can be increased by using Supplemental buccal infiltration, periodontal ligament injection, Intraosseous anesthesia and Oral premedication. Studies have shown that use of oral premedication with NSAIDS and Steroids improved the success rate of IANB in Symptomatic irreversible pulpitis. The purpose of this study is to evaluate the effect of oral premedication with 4mg Dexamethasone and combination of 800mg Ibuprofen and .5mg Dexamethasone on the anesthetic success of IANB in patients with Symptomatic irreversible pulpitis.