Efficacy Of Inferior Alveolar Nerve Block Plus Buccal Infiltration Versus Inferior Alveolar Nerve Block Plus Buccal And Lingual Infiltration In Patients With Irreversible Pulpitis

Abstract

Introduction: - Dental practitioners are always seeking materials and techniques to manage pain during and after root canal treatment. It is desirable to achieve maximum local anesthesia during endodontic treatment so the practitioner can focus on the procedure without being worried about the patient having pain or discomfort. This study is design to investigate the anesthetic efficacy of supplemental LI of the mandibular molars following IANB plus BI. The anesthetic efficacy of an additional LI of the mandibular molars, following IANB plus LI especially in patients with irreversible pulpitis, has not been investigated adequately. The necessity of supplemental LI depends on its ability of enhancing the anesthetic efficacy. More evidence is required to provide helpful suggestions for clinical situations.

 Objective: - To compare the efficacy of Inferior Alveolar Nerve Block plus buccal infiltration versus Inferior Alveolar Nerve Block plus buccal and lingual infiltration in patients with irreversible pulpitis.

 Setting: Institute of dentistry LUMHS, Jamshoro

 Duration: Six months from 1-7-2015 to 31-12-2015

 Design: Randomized clinical trial.

 Subject and Methods: A total of 60 patients with mandibular molars teeth and showed positive lip numbness after IANB were included in this study. Patients were randomly allocated into two groups. Thirty patients were received buccal infiltration and 30 patients were received buccal plus lingual infiltration. If the patients complained of moderate or severe pain during access, the initial instrumentation was omitted at the first visit. Success of the pulpal anesthesia was defined as no pain (VAS score = 0) or mild pain (VAS score 54 mm) at any stage of endodontic treatment.

Results: The average age of the patients was 43.17±9.71 years in lidocaine group and 41.10±11.88 in articane group. There were 28(46.7%) male and 32(53.3%) female. Efficacy was significantly high in lidocaine group as compared to articane group (83.3% vs. 56.7%; p=0.024).

 Conclusion: In conclusion, IANB (lidocaine) plus buccal infiltration (articaine) plus lingual increases the success rate of inferior alveolar nerve block in patients with irreversible pulpitis, although none of the techniques provided an acceptable success rate. The necessity of supplemental LI depends on its ability of enhancing the anesthetic efficacy. More evidence is required to provide helpful suggestions for clinical situations.