Pulikkotil SJ, et al. - In this systematic review and network meta-analysis (NMA) experts studied the most effective oral premedication for the anaesthetic success of inferior alveolar nerve blocks (IANB) in cases of irreversible pulpitis. Anaesthetic success was significantly increased by oral premedication with dexamethasone, NSAIDs or Tramadol. Dexamethasone or NSAIDs were seen to be superior to any other premedications. Dexamethasone 0.5 mg was most effective, followed by ketorolac 10 mg, piroxicam 20 mg, ibuprofen 400 mg + acetaminophen 500 mg and Tramadol 50 mg as seen on subgroup analyses of specific dosages in comparison with placebo. Significantly improved IANB success was seen with ibuprofen 400 mg, 600 mg and 800 mg, while Ibuprofen 300 mg had no impact.