Effect of ibuprofen on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis: A meta-analysis

Aust Endod J. 2019 Aug;45(2):246-258. doi: 10.1111/aej.12306. Epub 2018 Oct 7.

Abstract

The aim of this study was to compare preventive ibuprofen administration to placebo on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis. A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, SIGLE, and grey literature. The risk of bias was evaluated through the Cochrane Collaboration's tool. The quality of evidence was assessed using the GRADE approach. Only seven studies remained for the meta-analysis. Administering ibuprofen before anaesthesia increased the success rate of injectable anaesthesia (RR = 1.79; 95% confidence interval (CI) 1.32-2.42; P = 0.0002) even in cases of symptomatic irreversible pulpitis (RR = 1.55; 95% CI 1.05-2.29; P = 0.03). The intensity of pain was lower for ibuprofen (standardised difference means (SMD) = -3.73; 95% CI -6.43 to -1.04; P = 0.007). Ibuprofen as premedication is beneficial for the success of inferior alveolar nerve block.

Keywords: ibuprofen; inferior alveolar nerve block; irreversible pulpitis; meta-analysis; systematic review.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Anesthetics, Local
  • Anti-Inflammatory Agents, Non-Steroidal
  • Double-Blind Method
  • Humans
  • Ibuprofen
  • Mandibular Nerve
  • Nerve Block*
  • Pulpitis*

Substances

  • Anesthetics, Local
  • Anti-Inflammatory Agents, Non-Steroidal
  • Ibuprofen