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논문 기본 정보

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학술저널
저자정보
Sivaramakrishnan, Gowri (Dental Training Department, Ministry of Health) Alsobaiei, Muneera (Dental Training Department, Ministry of Health) Sridharan, Kannan (Department of Pharmacology & Therapeutics, College of Medicine and Medical Sciences, Arabian Gulf University)
저널정보
대한치과마취과학회 Journal of dental anesthesia and pain medicine Journal of dental anesthesia and pain medicine 제19권 제6호
발행연도
2019.1
수록면
323 - 341 (19page)

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Background: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials. Methods: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality. Results: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia. Conclusion: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.
#Pain #Pulpitis #Root Canal Therapy

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참고문헌 (87)

참고문헌 신청
Boyce RA / 2016 / Updates of topical and local anesthesia agents / Dent Clin North Am :445~471 google schola Thomas R / 2015 / How pain is controlled in endodontic therapy / SAAD Dig 31:32~37 google schola Virdee SS / 2015 / Effective anesthesia of the acutely inflamed pulp: part 2. Clinical strategies / Br Dent J 219:439~445 google schola Kung J / 2015 / Does articaine provide an advantage over lignocaine in patients with symptomatic irreversible pulpitis? a systematic review and meta-analysis / J Endod 41:1784~1794 google schola Su N / 2016 / Efficacy and safety of articaine versus lignocaine for irreversible pulpitis treatment : A systematic review and meta-analysis of randomised controlled trials / Aust Endod J 42:4~15 google schola

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