Postoperative Pain After Dexamethasone Injection by Two Techniques in Irreversible Pulpitis

the previous studies used dexamethasone with LA to prolong the duration of nerve block , Dexamethasone is used in reducing intraoperative endodontic pain the study main aim is to overcome the problem of severe postoperative pain after endodontic treatment in patients with acute irreversible pulpitis by evaluating the effect of dexamethasone in two different techniques by giving dexamethasone injection of buccinator muscle, or dexamethasone as buccal infiltration, and comparing the results with inferior alveolar nerve block using local anesthesia only. pain score evaluated using VAS score preoperatively and postoperatively with different anesthetic techniques after endodontic treatment.and their effet on frequency of analgesic intake

Inclusion criteria

• 1- Both genders 2- Older than age of (18 to 60) years 3- Participants willing to commit for the entire period of the trial and agreed to sign the written consent after full explanation of the study 4- Having a mandibular molar tooth with vital pulp 5- These patients were also suffering from symptomatic irreversible pulpitis ,intermittent or continuous sharp pain that lasts longer after removal of the stimulus 6- Patients with moderate to severe symptoms VAS≥4

Exclusion criteria

• 1- Vulnerable group; pregnant females, mentally ill and diseased patientsetc.… 2- Patients irritable to local anesthesia 3- Patients who are supposed to take plain anesthesia 4- Use of analgesic or antibiotic within 6 hours before the visit 5- Absence of bleeding in the pulp chamber during cavity preparation 6- Severe periodontal disease b- Patients' randomization, allocation and blinding: