This randomized controlled trial aims to compare the anesthetic efficacy of 2% lignocaine administered through an inferior alveolar nerve block (IANB) in one group of participants with 4% articaine delivered via primary buccal infiltration in other group in patients with symptomatic irreversible pulpitis in mandibular first molars.
Systemically healthy patients classified as ASA I, aged 18-55 years.
Permanent mandibular first molar tooth requiring endodontic therapy.
Diagnosed with symptomatic irreversible pulpitis without swelling or sinus.
Normal periapical radiographic appearance (no evidence of periapical pathology).
• Pregnant or lactating mothers.
Teeth with reversible pulpitis, previously treated, or with calcified canals.
Teeth with severe periodontal disease or periapical radiolucency.
Patients who have taken analgesics or anti-inflammatory drugs within 6 hours before the treatment visit.
Parallel
INTERVENTION 1: 2% Lignocaine 1:80,000 epinephrine
Other intervention2% Lignocaine Inferior Alveolar Nerve Block (IANB) : Participants in this group will receive an inferior alveolar nerve block using 2% Lignocaine with 1:80,000 epinephrine. The injection will be administered following standard IANB technique for mandibular first molars. The anesthetic efficacy will be assessed with 2 consecutive non responsive readings on EPT objectivelt and via Heft-Parker VAS not more than ≥55 .
INTERVENTION 2 : 4%Articaine 1:100,000 epinephrine
Other interventionParticipants in this group will receive a buccal infiltration of 4% Articaine with 1:100,000 epinephrine at the site of the mandibular first molar. The injection will follow standard buccal infiltration technique. Anesthetic efficacy will be evaluated during endodontic treatment using the same pain assessment method as Arm 1.
Anesthetic efficacy
Description: Patients will be assigned to one of the two groups . Group 1: 2%Lignocaine 1;80,000 epinephrine 1.8 ml IANB Group 2: 4%Articaine 1:100,000 epinephrine 1.8 ml Primary buccal infilteration Efficacy will be considered if there are 2 consecutive non-responsive readings during 60 mins duration , usually measured on EPT 15 mins after administration of anesthesia . Any pain felt during the procedure will be measured according to Heft-Parker VAS and moderate-severe pain reported (VAS ≥ 55) will be regarded unsuccessful . Time Frame: 1 hour after administration of local anesthetic agent .
Duration of anesthesia
Description: Duration up to which Lignocaine IANB/Articaine Primary Buccal Infilteration remains successful after administration . Time Frame: 1 hour 30 mins
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Armed Forces Institute of Dentistry, Pakistan
Lead sponsor
Armed Forces Post Graduate Medical Institute (AFPGMI), Rawalpindi
Sponsor institution
