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Preemptive use of corticosteroids enhances success of local anesthesia among patients undergoing endodontic therapy: Study
Preemptive use of corticosteroids enhances the success of local anaesthesia among patients undergoing endodontic therapy suggests a study published in the Journal of Endodontics.
Chronic inflammation in irreversible pulpitis leads to heightened sensitivity of nociceptive receptors, resulting in persistent hyperalgesia. This poses significant challenges in achieving effective anesthesia for patients with irreversible pulpitis. Various anesthetic techniques and pharmacological approaches have been employed to enhance the success of local anesthesia. Recently, the preemptive use of anti-inflammatory agents, specifically corticosteroids, has gained attention and shown promising results in randomized controlled trials. This systemic review and meta-analysis aimed to evaluate the impact of systemically administered corticosteroids on enhancing anesthetic success in patients undergoing endodontic treatment. A comprehensive search was conducted across multiple databases including PubMed, Cochrane Library, Embase, Scopus, Dentistry & Oral Science, and ProQuest. Additionally, the references of primary studies and related systematic reviews were manually searched for additional relevant publications.
The primary outcome assessed was the success of anesthesia, and the effect measure was Risk Ratio (RR) using the random-effects inverse variance method. Statistical significance was set at p < .05. The certainty of the evidence was evaluated using the GRADE approach. Results: Twelve studies involving 917 participants were analyzed to determine the frequency of successful anesthesia. The corticosteroid group demonstrated a significantly higher number of patients achieving successful anesthesia (RR = 1.66; 95% CI, 1.34 to 2.06;p< .00001). However, heterogeneity within the pooled data analysis was observed (I2= 57%,p=0.007). Moderate certainty evidence indicates that preemptive use of systemic corticosteroids enhances the success of local anesthesia, specifically inferior alveolar nerve block (IANB), in cases of irreversible pulpitis.
Reference:
Alajlan N, Carrasco-Labra A, Karabucak B, Lee SM. Systemic Corticosteroid Uses in Endodontics- Part 2: Enhancing the Success of Local Anesthesia. J Endod. 2024 Mar 13:S0099-2399(24)00161-4. doi: 10.1016/j.joen.2024.03.002. Epub ahead of print. PMID: 38490300.
Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751