Anesthetic Efficacy of Gow-Gates Versus Conventional Inferior Alveolar Nerve Block Techniques

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to determine whether Gow Gates block injection is more effective than conventional alveolar nerve block in anesthetising mandibular molars with acute pulpitis.

Detailed Description
-----------------
Pain management and adequate anesthesia are of critical importance for the endodontist. Traditionally, mandibular teeth are anesthetized via inferior alveolar nerve block (IAN). However, this technique provides a marginal success rate of 19-56% in patients with irreversible pulpitis.Gow Gates technique introduced in 1973 for anesthetizing of mandibular molars with more accuracy, success and safety.

Official Title
-----------------
Comparison of the Anesthetic Efficacy in Mandibular Molars With Acute Irreversible Pulpitis With Either Conventional Inferior Alveolar or Gow-gates Nerve Block Techniques Plus Buccal or Lingual Infiltration

Conditions
-----------------
Anesthesia; Reaction, Pain

Intervention / Treatment
-----------------
* Procedure: Type of block injection


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Mandibular molars with acute irreversible pulpitis Exclusion Criteria: Unhealthy patients Patients who had taken pain killer less than 4 hours before appointment

Ages Eligible for Study
-----------------
Minimum Age: 12 Years
Maximum Age: 50 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Gow gates ,conventional block injection<br>Patients will be selected from a group with acute irreversible pulpitis in mandibular molars. Half of the patients randomly selected for receiving gow gates block injection and half will receive traditional inferior block injection by 3.6 ml Lidocaine plus epinephrine.Teeth with no response to anesthetizing will be randomly divided into two group of either buccal or lingual infiltration. | Procedure: Type of block injection<br>* Patients will be selected from a group with acute irreversible pulpitis in mandibular molars. Half of the patients randomly selected for receiving gow gates block injection and half will receive traditional inferior block injection by 3.6 ml Lidocaine plus epinephrine.Teeth with no response to anesthetizing will be randomly divided into two group of either buccal or lingual infiltration.<br>* Other names: Conventional inferior block injection;|
| No Intervention: Buccal infiltration, Lingual infiltration<br> | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participant who will have pain following Gow gates or traditional inferior alveolar nerve block | All participant asked to show their pain degree on VAS for evaluation the efficacy of two different block injections and two different infiltrations ( Buccal and lingual) as supplementary injections. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart rate monitoring | These records will be monitored by pulse oximeter device | before and after block injections (day 1) |