Efficacy of Ketorolac infiltration on success rate of inferior alveolar nerve block in patients with irreversible pulpitis: A randomized double blinded clinical trial

Objectives: The aim of this study is to examine whether combining an intraoral injection of a non steroidal anti-inflammatory drug (Ketorolac), in association with conventional inferior alveolar nerve block, would improve the success rate in teeth with irreversible pulpitis. Design: Randomized double blind clinical trial Setting and conduct: Forty adult volunteers will randomly divide into two groups (n=20). All patients will receive standard infra alveolar nerve block of 4% Articaine with 1:100000 epinephrine and supplemental buccal infiltration of 0.9 mL 4% Articaine with 1:100000 epinephrine. After five minutes one group will receive supplemental buccal infiltration of 30 mg/mL of Ketorolac Tromethamine and other group will receive buccal infiltration of normal saline. Endodontic access preparation will initiate after 15 minutes of initial IANB with two negative responses to the electric pulp test. Pain during dentin, access cavity preparation and root canal instrumentation will be recorded using VAS. The success is considered as none or mild pain during treatment. The data will be analyzed using Mann-U-Whitney and chi-squared tests. Participants including major eligibility criteria: all patients with symptomatic irreversible pulpitis (Heft Parker visual analogue scale ≥54) of a mandibular molar tooth without systemic diseases; non smoking; without any medicine consumption or analgesic and sedation Intervention: Ketorolac infiltration Main outcome measures : Pain قشفث during dentin removal , access cavity preparation and root canal instrumentation using visual analyzing scale

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