In a recent study, premedication with Ibuprofen, Dexamethasone, Ketorolac, and Meloxicam was associated with improvement in the effectiveness of inferior alveolar nerve blocks (IANB) for mandibular molars with symptomatic irreversible pulpitis. Elnaghy AM et al. aimed to investigate the effect of oral premedication on the success of IANB of mandibular posterior teeth in individuals experiencing pulpitis.

In this randomized controlled study, sixty minutes prior to the administration of an IANB, 250 emergency subjects with moderate to severe pain and a diagnosis of pulpitis of a mandibular first or second molar were given similar capsules containing either Ibuprofen 600 mg, Meloxicam 7.5 mg, Dexamethasone 0.5 mg, Ketorolac 10 mg, or placebo.

After 15 minutes, an evaluation of noticeable lip numbness was done. IANB's success was then determined by preparing the access cavities and measuring the Heft Parker visual analogue scale [VAS] records for pain throughout access preparation and root canal instrumentation. In this prospective, double-blind trial, Kruskal-Wallis and chi-square tests were used to examine the data.

The success rates were found to be 52%, 64%, 54%, and 58% for the premedication groups of Meloxicam, Ketorolac, Dexamethasone, and Ibuprofen, respectively and did not differ noticeably among the groups. But, the tested premedications demonstrated a profound variation (32% success rate) in comparison to the placebo group. Therefore, premedication with Meloxicam, Ketorolac, Dexamethasone, and Ibuprofen was promising to improve IANB efficiency in pulpitis.