4% Articaine and 2% Lidocaine by Intraligamentary Technique in Irreversible Pulpitis
Condition: Irreversible Pulpitis
MeSH terms: Pulpitis
Study type: Interventional
Phase: Phase 3

Summary: 
      This study compared the anesthetic efficacy between Lignocaine and articaine administering it
      intraligamentarly using ligajet in twenty five female patients having irreversible pulpitis
      on bilateral mandibular molars. At 5minutes of post injection, the teeth were isolated with
      rubber dam and access performed. Patients were instructed to definitively rate any pain felt
      during endodontic procedure. If patient felt pain, the treatment was immediately stopped and
      the patient rated their discomfort using Heft Parker VAS. The extent of access achieved when
      the patient felt pain was recorded as within dentin, entering the pulp chamber or initial
      file placement. The success was defined as the ability to access and instrument the tooth
      without pain (VAS score of zero) or mild pain (VAS rating<54mm).
    

Detailed description: 
      The present clinical study was carried out to compare the anaesthetic success of 4% articaine
      with 2% lidocaine for intraligamentary anaesthesia in patients having irreversible pulpitis.

      Subjects randomly received two intraligamentary injections using Ligaject at a two separate
      appointments spared one week apart in a cross over design. Twenty patients received
      intraligamentary injections of 0.9 ml of 4%articaine with 1:100,000 epinephrine (Septodont
      INC) at first appointment and 1.8 ml of lidocaine with 1:100,000 epinephrine. Each patient
      served as her own control. All injections were given by the same physician or author. The
      injection was performed by inserting the needle at the gingival sulcus at the mesio-buccal
      line angle of the tooth with needle directed at approximately 30degrees angle to the long
      axis of the tooth in the buccolingual plane. Needle was placed into the sulcus with the bevel
      placing away from the tooth and towards the alveolar bone. Needle was advanced with a firm
      pressure until it could be advanced no further.

      The operator waited 10 seconds before slowly removing the needle from the injection site.
      This step supposedly allows the anaesthetic solution to dissipate within the tissue and
      reduces the amount of anaesthetic solution to dissipate within the tissue and reduces the
      amount of solution dripping from the site before needle withdrawal. However, in almost all
      cases some anaesthetic solution escaped upon removal of needle from the sulcus.

      Five minutes post injection, the teeth were isolated under rubber dam isolation and
      investigator performed the access cavity. Patients were instructed to definitely rate any
      pain felt during endodontic procedure. If patient felt pain, the treatment was immediately
      stopped and the patient rated her discomfort using Heft Parker VAS. The extent of access
      achieved when the patient felt pain was recorded as within dentin, entering the pulp chamber
      or initial file placement. The success was defined as the ability to access and instrument
      the tooth without pain (VAS score of zero) or mild pain (VAS rating<54mm).
    

Intervention name(s): 4%articaine; 2% Lignocaine; Epinephrine
Intervention type(s): Drug; Drug; Drug
Intervention description(s): intraligamentary injections of 0.9 ml of 4%articaine and 1:100,000 epinephrine; Intraligamentary injections of 1.8 ml of lidocaine and 1:100,000 epinephrine; Intraligamentary injections of 1.8 ml of lidocaine and 1:100,000 epinephrine
Intervention MeSH terms: Lidocaine; Epinephrine; Carticaine
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Intarligamentary; Articaine; Lidocaine