SP-40 Emergency Treatment of Acute Irreversible Pulpitis in Mandibular Molars with One IAN Block of a Long-acting Anaesthetic and One-day Large Dose Corticosteroid Without a Pulpotomy or Pulpectomy

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The emergency treatment of acute irreversible pulpitis in mandibular molars is challenging. Determining the causative tooth can be challenging due to the patient’s anxiety, the nature of the disease and the limitations of the diagnostic tests. Moreover, satisfactory pulpal anesthesia may not be obtained easily, rendering the unscheduled appointment even longer and disrupting treatment for patients with booked appointments. In this context, a simple endodontic procedure may become a burden to the patient and the dentist. Effective pain relief can be achieved for at least three days following the administration of a long-acting local anesthetic and a large single-day dose oral corticosteroid, without a pulpotomy or pulpectomy. This new protocol is based on the results of a clinical study which assessed pain levels for three days following one IAN block of bupivacaine and a large single-day dose oral dexamethasone given to patients presenting with acute irreversible pulpitis in mandibular molars.

At the conclusion, participants should be able to:

  • Describe the mechanism of action of corticosteroids.
  • List the contraindications to the use of corticosteroids.
  • Describe the emergency treatment of an acute irreversible pulpits in mandibular molars with one IAN block of a long-acting anesthetic and a large single-day dose of dexamethasone.


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Ghassan Yared, D.D.S., M.Sc.

Dr. Ghassan Yared is an endodontist practicing in Ontario, Canada. He completed his endodontic specialty training at University Paris VII, (Paris, France) in 1987 and obtained his M.Sc. from the Lebanese University (Beirut, Lebanon) in 1994. Dr. Yared has been extensively involved in teaching. He joined the Faculty of Dentistry Lebanese University in Beirut, Lebanon in 1988 and became Professor and Head of the Department of Endodontics; he also created and chaired the Department of Research. He joined the Department of Endodontics at the University of Toronto, Canada in 1999 for a full-time position as Assistant Head of the Department of Endodontics and Director of the Endodontic Undergraduate Programme. He remained at that position as Professor until summer 2004. He was Acting Head of the Department of Endodontics for 2003 and 2004. Dr. Yared has been elected for 4 consecutive years as the "Best Teacher of the Year", and has received the "Master Bruce Howard Award for Excellence in Teaching" the highest teaching award at the Faculty of Dentistry, University of Toronto. Dr. Yared has supervised the research projects of graduate endodontic students at the University of Toronto and has published extensively in peer-reviewed international endodontic journals. He has also given numerous lectures and continuous education courses worldwide. Dr. Yared is a reviewer for the International Endodontic Journal, the Journal of Endodontics, Endodontic Topics, and for Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. He is also a member of the Canadian Academy of Endodontology and the American Association of Endodontists.

Ghassan Yared, D.D.S., M.Sc.

I declare that I have proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.
Real World Endo (Self) :VDW Dentsply () : Consultant, Honorarium, Other Financial or Material Support, Royalties