Effect of Sodium Bicarbonate Buccal Infiltration on the Success of Inferior Alveolar Nerve Block

Study Overview
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Brief Summary
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The purpose of this prospective, randomized, double blind study was to evaluate the effect of a buccal infiltration of sodium bicarbonate on the anesthetic success of the inferior alveolar nerve block (IANB) in patients with mandibular first molar experiencing symptomatic

Detailed Description
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Several studies have been done by adding Sodium Bicarbonate to local anesthesia in dentistry based on the theory that the amount of local anesthetic in the free-base un-ionized form will decrease to provide greater lipid penetration of the nerve and this could be cause of the failure of local anesthesia injected into the inflamed tissue with low PH and conflicting results were obtained. But, there are no study that evaluate effect of increasing PH in periradicular tissue on hindrance of resistance channels with supplementary infiltration injection of Sodium Bicarbonate

Official Title
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Effect of Sodium Bicarbonate Buccal Infiltration on the Success of Inferior Alveolar Nerve Block in the Mandibular First Molar With Symptomatic Irreversible Pulpitis: a Prospective, Randomized Double-blind Study

Conditions
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Local Anesthesia

Intervention / Treatment
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* Drug: sodium bicarbonate
* Drug: Lidocaine
* Drug: sterile distilled water


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: vital mandibular molar tooth diagnosis of symptomatic irreversible pulpitis Exclusion Criteria: younger than 18 years old history of significant medical conditions allergies to local anesthetics or sulfites pregnancy taking any medications that might influence anesthetic assessment active sites of pathosis in area of injection inability to give informed consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: sodium bicarbonate<br>0.7 mL of 8.4% sodium bicarbonate & 0.3 mL of 2% lidocaine with 1:100,000 epinephrine | Drug: sodium bicarbonate<br> <br> Drug: Lidocaine<br> <br> |
| Active Comparator: Non-sodium bicarbonate<br>Sterile distilled water & 0.3 mL of 2% lidocaine with 1:100,000 epinephrine | Drug: Lidocaine<br> <br> Drug: sterile distilled water<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| success rate of IANB in the mandibular first molar with symptomatic irreversible pulpitis |  | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heft-Parker visual analog scale recording of pain |  | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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inferior alveolar nerve block, irreversible pulpitis, local anesthesia, sodium bicarbonate