Modaresi Jalil, Dianat Omid, Mozayeni Mohammad Ali
Department of Endodontics, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd and Isfahan, Iran.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Sep;102(3):399-403. doi: 10.1016/j.tripleo.2005.10.053. Epub 2006 Jun 27.
The purpose of this study was to elucidate whether premedication therapy with acetaminophen-codeine or ibuprofen is able to increase the depth of anesthesia in inflamed teeth. Sixty patients with the diagnosis of irreversible pulpitis in 1 mandibular tooth requiring root canal therapy (RCT) were selected. Two other teeth in the same quadrant were selected as controls. An electric pulp tester (EPT) was used to evaluate pulp sensitivity at the baseline and after drug administration and anesthesia injection. The subjects were divided into 3 groups randomly, and in each group 1 of the 3 drugs including acetaminophen-codeine, ibuprofen, and placebo were administered 1 hour before anesthesia delivery. After 1 hour, anesthesia was injected and after a waiting period, the EPT measurement was recorded. The reversed EPT scale was used to evaluate the depth of anesthesia achieved during RCT. Data were analyzed to statistically compare the results before and after intervention in cases and controls of each group and among different groups. Significanly lower tooth sensitivity levels (TSLs) were observed after intervention in acetaminophen-codeine and ibuprofen groups, which was more significant in the ibuprofen group. The comparison of inflamed teeth TSLs in the acetaminophen-codeine group and the placebo group after anesthesia and drug administration showed significant differences (P = .001). This comparison between ibuprofen and placebo groups also showed significant differences (P approximately 0). Also, significantly lower TSL of inflamed teeth was observed in the ibuprofen group in comparison with the acetaminophen-codeine group (P = .002). This study reflected preoperative administration of ibuprofen, if not contraindicated, as a drug of choice 1 hour before local anesthesia injection as an effective method for achieving a deep anesthesia during RCT of teeth with irreversible pulpitis.
本研究的目的是阐明对乙酰氨基酚 - 可待因或布洛芬进行术前用药治疗是否能够增加患牙的麻醉深度。选取了60例诊断为下颌1颗牙齿不可逆性牙髓炎且需要进行根管治疗（RCT）的患者。选取同一象限的另外两颗牙齿作为对照。使用牙髓电活力测试仪（EPT）在基线、给药后及注射麻醉药后评估牙髓敏感性。将受试者随机分为3组，每组在注射麻醉药前1小时给予3种药物中的1种，包括对乙酰氨基酚 - 可待因、布洛芬和安慰剂。1小时后，注射麻醉药，经过等待期后，记录EPT测量结果。使用反向EPT量表评估RCT期间达到的麻醉深度。对数据进行分析，以统计学方式比较每组病例和对照干预前后的结果以及不同组之间的结果。对乙酰氨基酚 - 可待因组和布洛芬组干预后观察到牙齿敏感水平（TSLs）显著降低，布洛芬组更显著。麻醉和给药后，对乙酰氨基酚 - 可待因组与安慰剂组患牙TSLs的比较显示出显著差异（P = 0.001）。布洛芬组与安慰剂组之间的这种比较也显示出显著差异（P约为0）。此外，与对乙酰氨基酚 - 可待因组相比，布洛芬组患牙的TSL显著更低（P = 0.002）。本研究表明，对于不可逆性牙髓炎患牙进行RCT时，若没有禁忌证，术前1小时注射局部麻醉药前给予布洛芬作为首选药物是实现深度麻醉的有效方法。
