Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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Efficacy of buccal piroxicam infiltration and inferior alveolar nerve block in patients with irreversible pulpitis: a prospective, double-blind, randomized clinical trial

  • Saurav Paul (Department of Conservative Dentistry and Endodontics, Rama Dental College, Hospital and Research Centre) ;
  • Sridevi Nandamuri (Department of Conservative Dentistry and Endodontics, Rama Dental College, Hospital and Research Centre) ;
  • Aakrati Raina (Department of Conservative Dentistry and Endodontics, Rama Dental College, Hospital and Research Centre) ;
  • Mukta Bansal (Department of Conservative Dentistry and Endodontics, Rama Dental College, Hospital and Research Centre)
  • Received : 2020.03.27
  • Accepted : 2020.09.02
  • Published : 2021.02.28
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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.

Keywords

Acknowledgement

The authors are grateful to every patient involved in this research for providing his/her consent, thereby allowing the completion of the trial.

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