The objective of the current study was to compare the anaesthetic efficacy of supplemental intraligamentary (IL) injection of 4% articaine with that of 2% lidocaine in the mandibular first and second molars with irreversible pulpitis after an ineffective inferior alveolar nerve block injection (IANB) using the same anaesthetic in a randomised triple-blind clinical trial. Seventy-six adult patients, who were diagnosed with irreversible pulpitis in the mandibular first or second molars, were divided into 2 groups and received IANB randomly. In patients with lip numbness, anaesthesia was evaluated with the cold and electrical pulp (EPT) tests, and if the reported number on EPT was below 100, supplemental IL injection was administered using the same anaesthetic. The teeth were retested after 5 minutes. The Heft–Parker visual analogue scale was used to evaluate pain after IANB and IL injections. Statistical analysis was performed using repeated measures ANOVA, chi-square, and independent-sample and paired-sample t-tests. The results showed that there was no significant difference in the success rates of supplemental IL and IANB injections between articaine and lidocaine. Furthermore, there was no significant difference in the success rates of supplemental IL injection with lidocaine between the mandibular first and second molars. However, there was a significant difference in the success rates of supplemental IL injection with articaine between the mandibular first and second molars. Moreover, supplemental IL injections indicated no significant difference in the anaesthetic efficacy between articaine and lidocaine; nevertheless, they were more effective in the mandibular second molars, especially with articaine.

中文翻译：

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4％青蒿素与2％利多卡因作为下颌磨牙不可逆性牙髓炎无效的下牙槽神经阻滞后鼻内注射的麻醉效果：一项前瞻性随机三盲临床试验

本研究的目的是比较无效的下牙槽神经阻滞注射（IANB）后，在不可逆性牙髓炎的下颌第一和第二磨牙中补充补充鼻内（IL）4％青蒿素和2％利多卡因的麻醉效果在一项随机的三盲临床试验中使用相同的麻醉剂。将76名在下颌第一或第二磨牙中被诊断为不可逆性牙髓炎的成年患者分为两组，并随机接受IANB治疗。对于唇部麻木的患者，通过冷和电浆（EPT）测试评估麻醉，如果报告的EPT数低于100，则使用相同的麻醉剂补充IL注射。5分钟后重新测试牙齿。Heft-Parker视觉模拟量表用于评估IANB和IL注射后的疼痛。使用重复测量方差分析，卡方，独立样本和配对样本进行统计分析t检验。结果表明，青蒿素和利多卡因之间补充IL和IANB注射的成功率没有显着差异。此外，下颌第一磨牙和第二磨牙之间的利多卡因补充IL注射成功率没有显着差异。但是，在下颌第一磨牙和第二磨牙之间用青蒿素补充IL注射的成功率存在显着差异。此外，补充IL注射表明阿替卡因和利多卡因之间的麻醉效果无显着差异。但是，它们在下颌第二磨牙中更有效，尤其是在使用青蒿素的情况下。