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The efficacy of supplemental intraseptal and buccal infiltration anesthesia in mandibular molars of patients with symptomatic irreversible pulpitis

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Abstract

Objective

The aim of this randomized clinical trial was to compare the success rate of three different anesthetic techniques in mandibular molars with symptomatic irreversible pulpitis.

Materials and methods

Ninety patients with symptomatic irreversible pulpitis in mandibular molars randomly received three anesthetic techniques. Group I: an inferior alveolar nerve block (IANB) of 2% lidocaine. Group II: IANB and buccal infiltration (BI) of 4% articaine. Group III: IANB + BI and intraseptal injection of articaine in each mesial and distal papilla. The pain (Heft-Parker visual analog scale (VAS)) and electric pulp tester (EPT) scores were recorded prior to (VAS1, EPT1) and after the injection and during access preparation (VAS2, EPT2). The success of anesthesia was defined as the ability to access the tooth with no or mild pain (VAS ≤ 54).

Results

The mean value for VAS2 was significantly less and the mean value for EPT2 was significantly more in groups II and III compared with group I. The success rates for groups I, II, and III were 30.33%, 66.66%, and 80.00% respectively. Also, differences of EPT2, VAS2, and success rates were statistically significant between groups II and III.

Conclusion

Administration of articaine as a supplemental intraseptal and BI following IANB can be considered a more successful anesthetic technique in mandibular molars with symptomatic irreversible pulpitis compared with the conventional IANB and supplemental BI.

Clinical relevance

The addition of an articaine intraseptal injection to IANB+BI technique may result in a significantly higher success rate of pulpal anesthesia in mandibular molars with symptomatic irreversible pulpitis.

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Acknowledgments

The authors would like to thank Dr. Pegah Ghiasi for her assistance in English editing and proof reading the manuscript. This article was part of Dr. Layeghnejad’s postgraduate thesis.

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Authors and Affiliations

  1. Division of Endodontics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA

    Omid Dianat

  2. Iranian Center for Endodontic Research, Research Institute of Dental Science, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Omid Dianat

  3. Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohamad Ali Mozayeni & Shiva Shojaeian

  4. Department of Endodontics, School of Dentistry, Yasuj University of Medical Sciences, Tehran, Iran

    Mohammad Karim Layeghnejad

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  1. Omid Dianat
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  2. Mohamad Ali Mozayeni
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  3. Mohammad Karim Layeghnejad
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  4. Shiva Shojaeian
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Corresponding author

Correspondence to Shiva Shojaeian.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the Ethics Committee of Dental Research Center of Shahid Beheshti University of Medical Sciences (Ethical code: IR.SBMU.RIDS.REC.1394.77) and was conducted according to the Consolidated Standards of Reporting Trials Statement and Helsinki Declaration of 1964 revised in 2000.

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Informed consent was obtained from all individual participants included in the study.

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Dianat, O., Mozayeni, M.A., Layeghnejad, M.K. et al. The efficacy of supplemental intraseptal and buccal infiltration anesthesia in mandibular molars of patients with symptomatic irreversible pulpitis. Clin Oral Invest 24, 1281–1286 (2020). https://doi.org/10.1007/s00784-019-03006-8

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  • DOI: https://doi.org/10.1007/s00784-019-03006-8

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