Systemic Corticosteroid Uses in Endodontics—Part 2: Enhancing the Success of Local Anesthesia

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CE Hours: 1.0

Description: 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.

At the conclusion of this article, the reader will be able to: 

  • Explain the inflammatory nature of pain in irreversible pulpitis and how it can adversely affect the success of local anesthesia, especially in mandibular molars.
  • Discuss the pharmacology of corticosteroids and their potent anti-inflammatory effect. 
  • Evaluate the body of evidence regarding the ability of corticosteroids in increasing the success of local anesthesia in irreversible pulpitis.

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Norah Alajlan, BDS, MS

Dr. Norah Alajlan earned her BDS degree from King Saud University, Riyadh, Saudi Arabia. Consequently, she obtained her post-graduate training in endodontics and Masters in Oral Biology from the University of Pennsylvania. Currently, she is working as a full- time faculty at King Saud University.

Alonso Carrasco-Labra, DDS, MSc, PhD

Bekir Karabucak, D.M.D., M.S.

Dr. Karabucak is Associate Professor/Clinician Educator, Interim Chair and Director of post-graduate program in the Department of Endodontics. Dr. Karabucak serves as director of Advanced Dental Education in the School of Dental Medicine. After earning his dental degree from Istanbul University School of Dental Medicine in 1993, Dr. Karabucak completed his endodontic postgraduate training at the Department of Endodontics at Penn, where he also received his Masters in Oral Biology in 1998. He later earned his DMD degree from Penn Dental Medicine in 2002. He’s the attending endodontist at the Children’s Hospital of Philadelphia since 2005. He is a Diplomate of the American Board of Endodontics. He lectured at national and international conferences and also serves as a reviewer for the Journal of Endodontics.

Su-Min Lee, DDS, MSD, DScD