SpringerLink
Log in

Comparative effectiveness of preemptive administration of ibuprofen and ibuprofen-arginine on the anesthetic success of inferior alveolar nerve block in teeth with symptomatic irreversible pulpitis – A double-blind randomized clinical trial

  • Research
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

This study examined the impact of premedication with ibuprofen and ibuprofen-arginine and the influence of preoperative pain and anxiety on inferior alveolar nerve block (IANB) efficacy in cases of symptomatic irreversible pulpitis.

Materials and methods

The study involved 150 SIP patients who were randomly assigned to receive ibuprofen (600 mg), ibuprofen-arginine (1,155 mg), or a placebo 30 min before IANB. Preoperative anxiety and pain levels were assessed using the Modified Dental Anxiety Scale and the Heft-Parker visual scale. IANB efficacy was determined by the absence of or mild pain during the procedure. Statistical analysis included chi-square, z-tests, Analysis of Variance, and Student's t tests.

Results

The ibuprofen and ibuprofen-arginine groups exhibited significantly higher IANB success rates (62% and 78%, respectively) compared to the placebo group (34%). However, no significant difference was observed between the ibuprofen and ibuprofen-arginine groups. Patients with successful IANB in the ibuprofen and ibuprofen-arginine groups displayed lower median anxiety scores (8) than those with failed blocks (15) and lower mean preoperative pain scores (118.3).

Conclusion

In cases of symptomatic irreversible pulpitis the preemptive medication with ibuprofen-arginine effectively increased the efficacy of the inferior alveolar nerve block The inferior alveolar nerve block efficacy was influenced by preoperative anxiety levels and the intensity of pain.

Clinical relevance

This research underscores the potential benefits of oral premedication with ibuprofen and ibuprofen-arginine in improving anesthesia outcomes in cases of symptomatic irreversible pulpitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Sorensen H, Skidmore L, Rzasa D et al (2004) Comparison of pulpal sodium channel density in normal teeth to diseased teeth with severe spontaneous pain. J Endod 30:287–288

    Google Scholar 

  2. Modaresi J, Dianat O, Soluti A (2008) Effect of pulp inflammation on nerve impulse quality with or without anesthesia. J Endod 34:438–441. https://doi.org/10.1016/j.joen.2008.01.014

    Article  PubMed  Google Scholar 

  3. Drum M, Reader A, Nusstein J, Fowler S (2017) Successful pulpal anesthesia for symptomatic irreversible pulpitis. J Am Dent Assoc 148:267–271. https://doi.org/10.1016/j.adaj.2017.01.002

    Article  PubMed  Google Scholar 

  4. Dou L, Vanschaayk MM, Zhang Y, Fu X, Ji P, Yang D (2018) The prevalence of dental anxiety and its association with pain and other variables among adult patients with irreversible pulpitis. BMC Oral Health 18:101–102. https://doi.org/10.1186/s12903-018-0563-x

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jensen MP, Karoly P, Braver S (1986) The measurement of clinical pain intensity: a comparison of six methods. Pain 27:117–126. https://doi.org/10.1016/0304-3959(86)90228-9

    Article  PubMed  Google Scholar 

  6. Bidar M, Mortazavi S, Forghani M, Akhlaghi S (2017) Comparison of effect of oral premedication with ibuprofen or dexamethasone on anesthetic efficacy of inferior alveolar nerve block in patients with irreversible pulpitis: a prospective, randomized, controlled, double-blind study. Bull Tokyo Dent Coll 58:231–236. https://doi.org/10.2209/tdcpublication.2016-0050

    Article  CAS  PubMed  Google Scholar 

  7. Parirokh M, Ashouri R, Rekabi AR et al (2010) The effect of premedication with ibuprofen and indomethacin on the success of inferior alveolar nerve block for teeth with irreversible pulpitis. J Endod 36:1450–1454. https://doi.org/10.1016/j.joen.2010.05.007

    Article  PubMed  Google Scholar 

  8. Noguera-Gonzalez D, Cerda-Cristerna BI, Chavarria-Bolaños D, Flores-Reyes H, Pozos-Guillen A (2013) Efficacy of preoperative ibuprofen on the success of inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a randomized clinical trial. Int Endod J 46:1056–1062. https://doi.org/10.1111/iej.12099

    Article  CAS  PubMed  Google Scholar 

  9. Jena A, Shashirekha G (2013) 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 16:171–174. https://doi.org/10.4103/0972-0707.108209

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Lapidus D, Goldberg J, Hobbs EH, Ram S, Clark GT, Enciso R (2016) Effect of premedication to provide analgesia as a supplement to inferior alveolar nerve block in patients with irreversible pulpitis. J Am Dent Assoc 147:427–437. https://doi.org/10.1016/j.adaj.2016.01.006

    Article  PubMed  Google Scholar 

  11. Modaresi J, Davoudi A, Badrian H, Sabzian R (2016) Irreversible pulpitis and achieving profound anesthesia: Complexities and managements. Anesth Essays Res 10:3–6. https://doi.org/10.4103/0259-1162.164675

    Article  PubMed  PubMed Central  Google Scholar 

  12. de Geus JL, Wambier LM, Boing TF, Loguercio AD, Reis A (2018) Effect of ibuprofen on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis: A meta-analysis. Aust Endod J 45:246–258. https://doi.org/10.1111/aej.12306

    Article  PubMed  Google Scholar 

  13. Esmaeili H, Malekzadeh M, Esmaeili D, Nikeghbal F (2020) Dental anxiety and the effectiveness of local anesthesia. Braz J Oral Sci 19:208–227. https://doi.org/10.20396/bjos.v19i0.8658127

    Article  Google Scholar 

  14. Corah NL (1969) Development of a dental anxiety scale. J Dent Rev 48:596. https://doi.org/10.1177/00220345690480041801

    Article  CAS  Google Scholar 

  15. Humphris GM, Morrison T, Lindsay SJ (1995) The modified dental anxiety scale: Validation and United Kingdom norms. Community Dent Health 12:143–150

    CAS  PubMed  Google Scholar 

  16. Aggarwal V, Singla M, Subbiya A, Vivekanandhan P, Sharma V, Sharma R, Prakash V, Geethapriya N (2015) Effect of preoperative pain on inferior alveolar nerve block. Anesth Prog 62(4):135–139. https://doi.org/10.2344/15-00019.1

    Article  PubMed  PubMed Central  Google Scholar 

  17. Nguyen V, Chen YW, Johnson JD, Paranjpe A (2020) In vivo evaluation of effect of preoperative ibuprofen on proinflammatory mediators in irreversible pulpitis cases. J Endod 46:1210–1216. https://doi.org/10.1016/j.joen.2020.06.009

    Article  PubMed  Google Scholar 

  18. Mokhtari F, Yazdi K, Mahabadi AM, Modaresi SJ, Hamzeheil Z (2016) Effect of premedication with indomethacin and ibuprofen on postoperative endodontic pain: A clinical trial. Iran Endod J 11:57–62. https://doi.org/10.7508/iej.2016.01.011

    Article  CAS  PubMed  Google Scholar 

  19. Mehlisch DR, Ardia A, Pallotta T (2003) Analgesia with ibuprofen arginate versus conventional ibuprofen for patients with dysmenorrhea: a crossover trial. Curr Ther Res Clin Exp 64:327–337. https://doi.org/10.1016/S0011-393X(03)00104-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Cajaraville JP (2021) Ibuprofen Arginate for rapid-onset pain relief in daily practice: A review of its use in different pain conditions. J Pain Res 25(14):117–126. https://doi.org/10.2147/JPR.S280571

    Article  Google Scholar 

  21. Ceppi Monti N, Gazzaniga A, Gianesello V, Stroppolo F, Lodola E (1992) Activity and pharmacokinetics of a new oral dosage form of soluble ibuprofen. Arzneimittelforschung 42:556–559

    CAS  PubMed  Google Scholar 

  22. Borea G, Monopoli R, Colantoni A (1996) Ibuprofen arginine vs naproxen sodium as prophylactic oral treatment of pain due to dental surgery: a randomised double-blind double-dummy placebocontrolled multicentre study. Clin Drug Investig 11:33–40

    Article  CAS  Google Scholar 

  23. Manso FJ, Bascones A, Maqueda MJ, Vadillo JM (1996) Controlled study on the efficacy and tolerability of ibuprofen-arginine vs.Aceclofenac in the control of pain after surgical extraction of lower molars. Rev Odontoestomatol 12:531–536

    Google Scholar 

  24. Black P, Max MB, Desjardins P, Norwood T, Ardia A, Pallotta T (2002) A randomized, double-blind, placebo-controlled comparison of the analgesic efficacy, onset of action, and tolerability of ibuprofen arginate and ibuprofen in postoperative dental pain. Clin Ther 24:1072–1089. https://doi.org/10.1016/s0149-2918(02)80020-0

    Article  CAS  PubMed  Google Scholar 

  25. Desjardins P, Black P, Papageorge M et al (2002) Ibuprofen arginate provides effective relief from postoperative dental pain with a more rapid onset of action than ibuprofen. Eur J Clin Pharmacol 58:387–394. https://doi.org/10.1007/s00228-002-0491-0

    Article  CAS  PubMed  Google Scholar 

  26. Humphris G, King K (2011) The prevalence of dental anxiety across previous distressing experiences. J Anxiety Disord 25:232–236. https://doi.org/10.1016/j.janxdis.2010.09.007

    Article  CAS  PubMed  Google Scholar 

  27. Williamson A, Hoggart B (2005) Pain: a review of three commonly used pain rating scales. J Clin Nurs 14:798–804. https://doi.org/10.1111/j.1365-2702.2005.01121.x

    Article  PubMed  Google Scholar 

  28. Cattaneo D, Clementi E (2010) Clinical pharmacokinetics of ibuprofen arginine. Curr Clin Pharmacol 5:239–245. https://doi.org/10.2174/157488410793352012

    Article  CAS  PubMed  Google Scholar 

  29. Ramos EU, Benetti LP, Oliveira JCS, Bassi APF (2022) Single-dose ibuprofen-arginine as a preventive for pain, edema, and trismus after impacted lower third molar surgery: A randomized split-mouth clinical trial. Eur J Dent 16:396–402. https://doi.org/10.1055/s-0041-1735910

    Article  PubMed  Google Scholar 

  30. Hegde V, Shanmugasundaram S, Shaikh S (2023) Effect of preoperative oral steroids in comparison to anti-inflammatory on anesthetic success of inferior alveolar nerve block in mandibular molars with symptomatic irreversible pulpitis - A double-blinded randomized clinical trial. J Endod 49:354–361. https://doi.org/10.1016/j.joen.2023.01.007

    Article  PubMed  Google Scholar 

  31. Aggarwal V, Singla M, Kabi D (2010) 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 36:375–378. https://doi.org/10.1016/j.joen.2009.11.010

    Article  PubMed  Google Scholar 

  32. Oleson M, Drum M, Reader A, Nusstein J, Beck M (2010) Effect of preoperative ibuprofen on the success of the inferior alveolar nerve block in patients with irreversible pulpitis. J Endod 36:379–382. https://doi.org/10.1016/j.joen.2009.12.030

    Article  PubMed  Google Scholar 

  33. Shantiaee Y, Javaheri S, Movahhedian A, Eslami S, Dianat O (2017) Efficacy of preoperative ibuprofen and meloxicam on the success rate of inferior alveolar nerve block for teeth with irreversible pulpitis. Int Dent J 67:85–90. https://doi.org/10.1111/idj.12272

    Article  PubMed  Google Scholar 

  34. Ianiro SR, Jeansonne BG, McNeal SF, Eleazer PD (2007) The effect of preoperative acetaminophen or a combination of acetaminophen and Ibuprofen on the success of inferior alveolar nerve block for teeth with irreversible pulpitis. J Endod 33:11–14. https://doi.org/10.1016/j.joen.2006.09.005

    Article  PubMed  Google Scholar 

  35. Nagendrababu V, Abbott PV, Pulikkotil SJ, Veettil SK, Dummer PMH (2021) Comparing the anaesthetic efficacy of 1.8 mL and 3.6 mL of anaesthetic solution for inferior alveolar nerve blocks for teeth with irreversible pulpitis: a systematic review and meta-analysis with trial sequential analysis. Int Endod J 54:331–342. https://doi.org/10.1111/iej.13428

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

No funding was obtained for this study.

Author information

Authors and Affiliations

  1. Department of Stomatology, School of Dentistry, Federal University of Goiás, Setor Universitário, Goiânia, GO, 74605-220, Brazil

    Jéssica Petini de Oliveira, Ana Helena Gonçalves de Alencar, Daniel A. Decurcio & Carlos Estrela

  2. Department of Endodontics, Paulista University, São Paulo, SP, Brazil

    Cristiane Bonanato Estrela

  3. Department Oral Biology, School of Dentistry and Medicine, Evangelical University of Goiás, Goiás, Brazil

    Cyntia R. A. Estrela

Authors
  1. Jéssica Petini de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ana Helena Gonçalves de Alencar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cristiane Bonanato Estrela
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniel A. Decurcio
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cyntia R. A. Estrela
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carlos Estrela
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

• Jéssica Petini de Oliveira—Conceptualization, Methodology, Formal analysis, Investigation; Writing – review & editing;

• Ana Helena Gonçalves de Alencar—Methodology, Conceptualization, Formal analysis, Investigation, Writing – review & editing;

• Daniel de Almeida Decurcio—Formal analysis Investigation Visualization, Writing – review & editing;

• Cristiane Bonanato Estrela—Formal analysis Investigation Visualization, Writing – review & editing;

• Cyntia RA Estrela—Conceptualization, Methodology, Formal analysis, Investigation, Writing – review & editing;

• Carlos Estrela—Software, Methodology, Conceptualization, Formal analysis, Investigation, Writing – review & editing;

Corresponding author

Correspondence to Daniel A. Decurcio.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The present project was approved by the Research Ethics Committee of the Federal University of Goiás (CAAE: 53207121.5.0000.5083), and written formal informed consent was obtained from all participants.

Conflict of interests

The authors deny any conflicts of interest related to this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Approved by the Research Ethics Committee of the Federal University of Goiás (CAAE: 53207121.5.0000.5083).

Registered on the Brazilian Registry of Clinical Trials platform ReBEC: RBR-6z4jrs8.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Oliveira, J.P., de Alencar, A.H.G., Estrela, C.B. et al. Comparative effectiveness of preemptive administration of ibuprofen and ibuprofen-arginine on the anesthetic success of inferior alveolar nerve block in teeth with symptomatic irreversible pulpitis – A double-blind randomized clinical trial. Clin Oral Invest 28, 366 (2024). https://doi.org/10.1007/s00784-024-05765-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00784-024-05765-5

Keywords

Search

Navigation