Anesthesia Techniques in Symptomatic Mandibular Molars With Irreversible Pulpitis
Condition: Anesthesia, Dental
MeSH terms: Pulpitis
Study type: Interventional

Summary: 
      The aim of this clinical study is to evaluate the success of buccal infiltration (BI)
      anesthesia + intraligamentary (ILI) anesthesia between inferior alveolar nerve block (IANB)
      anesthesia + buccal infiltration anesthesia in mandibular molar teeth with acute symptomatic
      irreversible pulpitis.The main questions it aims to answer are:

        -  Does the anesthesia techniques adequate to perform root canal treatment painlessly?

        -  Which technique achieved pulpal anesthesia? Participants were allocated in two groups
           according to the randomization blocks, with a total of 25 patients in each group. In
           IANB + BI anesthesia techniques, a total of approximately 2.8 ml of anesthetic solution,
           1.8 ml + 1 ml, was applied, while for BI + ILI, a total of approximately 1.72 ml, 1 ml +
           0.72 ml, was administered. Then, root canal treatment was performed.

      Researchers were compared the success of anesthesia techniques in different stages of root
      canal treatment.
    

Detailed description: 
      A total of 50 patients, aged between 18-65, who were diagnosed with symptomatic irreversible
      pulpitis of the mandibular molar tooth, were included in this study. The patients were
      allocated in two groups according to the randomization blocks, with a total of 25 patients in
      each group. In IANB + BI anesthesia techniques, a total of approximately 2.8 ml of anesthetic
      solution, 1.8 ml + 1 ml, was applied, while for BI + ILI, a total of approximately 1.72 ml, 1
      ml + 0.72 ml, was administered. After the anesthesia, a rubber dam was placed on the
      associated tooth of the patient for root canal treatment, the endodontic access cavity was
      opened, and canal preparation procedures were started. The pain levels felt by the patients
      during the endodontic treatment stages (starting the treatment, opening the endodontic access
      cavity and pulp extirpation) were determined by Heft-Parker VAS (HP-VAS) scale. Anesthesia
      was considered successful in patients who felt no pain (HP-VAS ratio = 0) or mild pain
      (HP-VAS ratio ≤ 54) during the procedures.
    

Intervention name(s): Inferior Alveolar Nerve Block Group; Intraligamentary Injection Group
Intervention type(s): Device; Device
Intervention description(s): A standard IANB injection with a conventional dental injector and a 27-G needle. After determining the injection site and performing aspiration, 1.8 mL of solution was injected at a rate of 1 mL/min to block the inferior alveolar nerve. After achieving lip anesthesia, infiltration was performed at the buccal side of the affected tooth with 0.5 mL using a normal syringe and a 27-G needle. The needle insertion point was the middle of the mesiodistal distance of the crown. Five minutes later, the teeth were isolated and the endodontic procedure was started.; An infiltration was performed at the buccal side of the affected tooth with 0.5 mL using a normal syringe and a 27-G needle. Then, an intraligamentary injection was performed with a special pressure injection syringe (Sopira Citoject, Kulzer, Hanau, Germany) and a 30-G needle. The needle was placed alongside the tooth and inserted at a 30 angle relative to the longitudinal axis of the crown with the needle between the teeth and the bone. Then, in the mesiobuccal, distobuccal, mesiolingual and distolingual portions of teeth, 0.18 mL of the solution was injected. Five minutes later, the teeth were isolated and the endodontic procedure was started.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary purpose: Treatment
Keywords: pain; irreversible pulpitis; intraligamentary injection; inferior alveolar nerve block