Efficacy of buccal piroxicam infiltration and inferior alveolar nerve block in patients with irreversible pulpitis: a prospective, double-blind, randomized clinical trial
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Objectives: This randomized clinical trial aimed to assess the effectiveness of buccal infiltration with piroxicam on the anesthetic efficacy of inferior alveolar nerve block (IANB) with buccal infiltration in irreversible pulpitis, with pain assessed using the Heft-Parker visual analogue scale (HP-VAS). Materials and Methods: This study included 56 patients with irreversible pulpitis in mandibular molars, randomly distributed between 2 groups (n = 28). After evaluating the initial pain score with the HP-VAS, each patient received IANB followed by buccal infiltration of 2% lignocaine with adrenaline (1:80,000). Five minutes later, the patients in groups 1 and 2 were given buccal infiltration with 40 mg/2 mL of piroxicam or normal saline, respectively. An access opening procedure (AOP) was performed 15 minutes post-IANB once the individual showed signs of lip numbness as well as 2 negative responses to electric pulp testing. The HP-VAS was used to grade the patient's pain during caries removal (CR), AOP, and working length measurement (WLM). Successful anesthesia was identified either by the absence of pain or slight pain through CR, AOP, and WLM, with no requirement of a further anesthetic dose. A statistical analysis was done using the Shapiro-Wilk and Mann-Whitney U tests. Results: The piroxicam group presented a significantly lower (p < 0.05) mean pain score than the saline group during AOP. Conclusions: Buccal infiltration with piroxicam enhanced the efficacy of anesthesia with IANB and buccal infiltration with lignocaine in patients with irreversible pulpitis.
Abstract
Objectives: This randomized clinical trial aimed to assess the effectiveness of buccal infiltration with piroxicam on the anesthetic efficacy of inferior alveolar nerve block (IANB) with buccal infiltration in irreversible pulpitis, with pain assessed using the Heft-Parker visual analogue scale (HP-VAS). Materials and Methods: This study included 56 patients with irreversible pulpitis in mandibular molars, randomly distributed between 2 groups (n = 28). After evaluating the initial pain score with the HP-VAS, each patient received IANB followed by buccal infiltration of 2% lignocaine with adrenaline (1:80,000). Five minutes later, the patients in groups 1 and 2 were given buccal infiltration with 40 mg/2 mL of piroxicam or normal saline, respectively. An access opening procedure (AOP) was performed 15 minutes post-IANB once the individual showed signs of lip numbness as well as 2 negative responses to electric pulp testing. The HP-VAS was used to grade the patient's pain during caries removal (CR), AOP, and working length measurement (WLM). Successful anesthesia was identified either by the absence of pain or slight pain through CR, AOP, and WLM, with no requirement of a further anesthetic dose. A statistical analysis was done using the Shapiro-Wilk and Mann-Whitney U tests. Results: The piroxicam group presented a significantly lower (p < 0.05) mean pain score than the saline group during AOP. Conclusions: Buccal infiltration with piroxicam enhanced the efficacy of anesthesia with IANB and buccal infiltration with lignocaine in patients with irreversible pulpitis.
참고문헌 (25)
- Handysides RA, "Ingle's endodontics" (2008), BC Decker Inc
- Ali SG, "Pulpitis: a review", IOSR J Dent Med Sci, 14, pp.92~97 (2015)
- Aggarwal V, "Comparative evaluation of effect of preoperative oral medication of ibuprofen and ketorolac on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis: a prospective, double-blind, randomized clinical trial", J Endod, 36, pp.375~378 (2010)
- Akhlaghi NM, "Efficacy of ketorolac buccal infiltrations and inferior alveolar nerve blocks in patients with irreversible pulpitis: a prospective, double-blind, randomized clinical trial", J Endod, 42, pp.691~695 (2016)
- Rogers BS, "Efficacy of articaine versus lidocaine as a supplemental buccal infiltration in mandibular molars with irreversible pulpitis: a prospective, randomized, double-blind study", J Endod, 40, pp.753~758 (2014)
- Prasanna N, "The efficacy of pre-operative oral medication of lornoxicam and diclofenac potassium on the success of inferior alveolar nerve block in patients with irreversible pulpitis:a double-blind, randomised controlled clinical trial", Int Endod J, 44, pp.330~336 (2011)
- Verma PK, "Anesthetic efficacy of X-tip intraosseous injection using 2%lidocaine with 1:80,000 epinephrine in patients with irreversible pulpitis after inferior alveolar nerve block: a clinical study", J Conserv Dent, 16, pp.162~166 (2013)
- Hargreaves KM, "Local anesthetic failure in endodontics: mechanisms and management", Endod Topics, 1, pp.26~39 (2002)
- Smith WL, "Cyclooxygenases: structural, cellular, and molecular biology", Annu Rev Biochem, 69, pp.145~182 (2000)
- Aggarwal V, "Comparative evaluation of local infiltration of articaine, articaine plus ketorolac, and dexamethasone on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis", J Endod, 37, pp.445~449 (2011)
- Brogden RN, "Piroxicam: a review of its pharmacological properties and therapeutic efficacy", Drugs, 22, pp.165~187 (1981)
- Shanbagh TV, "Pharmacology for dental students" (2010), Elsevier
- Wiseman RL, "Intramuscular piroxicam, a new dosage form, in the treatment of acute musculoskeletal disorders", J Int Med Res, 13, pp.255~262 (1985)
- Cohen HP, "Endodontic anesthesia in mandibular molars: a clinical study", J Endod, 19, pp.370~373 (1993)
- Parirokh M, "Efficacy of combining a buccal infiltration with an inferior alveolar nerve block for mandibular molars with irreversible pulpitis", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 109, pp.468~473 (2010)
- Masoud Parirokh, "The success rate of bupivacaine and lidocaine as anesthetic agents in inferior alveolar nerve block in teeth with irreversible pulpitis without spontaneous pain", Restorative Dentistry and Endodontics, 40(2), pp.155~160 (2015), 대한치과보존학회
- Kaviani N, "The effect of orally administered ketamine on requirement for anesthetics and postoperative pain in mandibular molar teeth with irreversible pulpitis", J Oral Sci, 53, pp.461~465 (2011)
- Vadivelu N, "Ketorolac tromethamine - routes and clinical implications", Pain Pract, 15, pp.175~193 (2015)
- Joshi N, "Comparative evaluation of the efficacy of two modes of delivery of Piroxicam (Dolonex®) for the management of postendodontic pain: a randomized control trial", J Conserv Dent, 19, pp.301~305 (2016)
- Atbaei A, "Prophylactic intraligamentary injection of piroxicam (feldene) for the management of post-endodontic pain in molar teeth with irreversible pulpitis", Aust Endod J, 38, pp.31~35 (2012)
- Subhan Z, "Comparison of prophylactic intraligamentary injection of piroxicam and lignocaine for management of postoperative endodontic pain", Pak Oral Dent J, 36, pp.480~483 (2016)
- Yadav S, "Anesthetic success of supplemental infiltration in mandibular molars with irreversible pulpitis: a systematic review", J Conserv Dent, 18, pp.182~186 (2015)
- Goddard G, "Reproducibility of visual analog scale (VAS) pain scores to mechanical pressure", Cranio, 22, pp.250~256 (2004)
- Averbuch M, "Assessment of visual analog versus categorical scale for measurement of osteoarthritis pain", J Clin Pharmacol, 44, pp.368~372 (2004)
- Jena A, "Effect of preoperative medications on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis: a placebo-controlled clinical study", J Conserv Dent, 16, pp.171~174 (2013)