Comparative evaluation of anesthetic efficacy of inferior alveolar nerve block and inferior alveolar nerve block plus buccal or lingual infiltration \ufeffusing articaine in mandibular molars with irreversible pulpitis: a preliminary prospective randomized single-blind clinical trial.

Abstract

OBJECTIVES\nThis study was designed as a prospective randomized single-blind clinical trial to compare the anesthetic efficacy of inferior alveolar nerve block (IANB), IANB plus buccal infiltration, and IANB plus lingual infiltration of 4% articaine with 1:100,000 epinephrine in mandibular molars with irreversible pulpitis.\n\n\nMETHOD AND MATERIALS\nSixty healthy volunteers who had a first or second mandibular molar diagnosed with irreversible pulpitis participated in the present study. This study was composed of three arms for the first molar and three arms for the second molar. Subjects in test arm A received two IANB injections (3.6 mL). Subjects in test arm B received 1.8 mL IANB injection plus 1.8 mL buccal infiltration. Subjects in test arm C received 1.8 mL IANB injection plus 1.8 mL lingual infiltration. Articaine (4%) with 1:100,000 epinephrine was used for all injections. The subject s pain during access preparation and pulp extirpation was recorded on the Heft-Parker visual analog scale. Success was defined as none or mild pain during treatment. Kruskal-Wallis test was used to compare pain categories in three groups of interventions for each mandibular molar.\n\n\nRESULTS\nIANB with a supplemented buccal infiltration provided more success than IANB alone or IANB plus lingual infiltration, in first molars (P = .019). There were no significant differences between \ufeffthe three injection techniques in second molars (P = .795).\n\n\nCONCLUSIONS\nAdding a supplemental buccal infiltration to a standard IANB was more successful in providing pain-free treatment for patients experiencing irreversible pulpitis in mandibular first molars.