Journal of Research and Advancement in Dentistry
Official publication of Magadh University and Kolhan University, Government of Bihar and Jharkhand, India
Official publication of Magadh University and Kolhan University, Government of Bihar and Jharkhand, India
Year : 2016
Volume : Volume 6
Issue : Issue 1s
Address for correspondence :
Dr. Sneha Ratnani
drsnehar@gmail.com
Background: The inferior alveolar nerve block (IANB) does not always provide satisfactory anesthesia for patients with irreversible pulpitis. Hence many a times supplementary local anesthetic techniques are required in order to achieve profound anesthesia for successful and pain free endodontic treatment. Materials and Method: The trial included 100 patients diagnosed with irreversible pulpitis in mandibular teeth. Patients received 2.0 ml of 2% lidocaine with 1: 80,000 epinephrine as an IANB injection. Patients who did not experience pain-free treatment received randomly 1 of 3 supplementary techniques, namely repeat lidocaine IANB (rIANB), articaine buccal infiltration (ABI), lidocaine intraligamentary injection (PDL). Successful pulp anesthesia was considered to have occurred when no response was obtained to the maximum stimulation (80 reading) of the pulp tester, at which time treatment commenced. Treatment was regarded as being successfully completed when it was associated with no pain. Data were analyzed by chi-square tests. Results: Of the 100 patients, 42 achieved successful pulpal anesthesia within 10 minutes after initial IANB injection. ABI allowed more successful (pain-free) treatment (40%) than rIANB or PDL supplementary techniques (28.6% and 31.4% respectively); but this difference was not statistically significant (p>0.005). Conclusion: IANB injection alone does not always allow pain-free treatment for mandibular teeth with irreversible pulpitis. Supplementary buccal infiltration with 4% articaine with epinephrine are more likely to allow pain-free treatment than intraligamentary and repeat IANB injections with 2% lidocaine with epinephrine for patients experiencing irreversible pulpitis in mandibular permanent teeth.
Keywords: Buccal infiltration, Inferior alveolar nerve block, Mandibular permanent teeth, Repeat Inferior Alveolar Nerve Block, Supplementary local anesthetic techniques.
