This multicenter randomized trial compares the clinical effectiveness of intraligamentary injection versus inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis in mandibular molars. The goal is to determine which technique provides better pain control during endodontic treatment.
Adults aged 18 years or older
Presenting with symptomatic irreversible pulpitis in a mandibular molar
Vital response to cold testing
Ability to understand and provide informed consent
Known allergy to lidocaine or epinephrine
Pregnancy or breastfeeding
Use of analgesics or anti-inflammatory drugs in the previous 6 hours
Non-vital or previously treated teeth
Parallel
Intraligamentary Injection
Procedure/SurgeryIntraligamentary local anesthesia will be administered using a standard dental syringe with 2% lidocaine and 1:100,000 epinephrine.
Inferior Alveolar Nerve Block
Procedure/SurgeryInferior alveolar nerve block will be performed with 2% lidocaine and 1:100,000 epinephrine using the conventional technique.
Pain during endodontic access
Pain intensity experienced by the patient during endodontic access after the assigned anesthetic technique.
Need for supplementary anesthesia
Whether the initial anesthesia technique was sufficient or required additional anesthetic injection to complete the procedure pain-free.
Patient satisfaction immediately after treatment
Patient-reported satisfaction immediately after treatment will be measured using a 5-point Likert scale. The scale ranges from 1 (very dissatisfied) to 5 (very satisfied). Higher scores indicate better satisfaction.
Postoperative pain at 7 days
Pain intensity reported by the patient at day 7 after treatment will be assessed using a 4-point ordinal scale: 1 (none), 2 (mild), 3 (moderate), 4 (severe). Higher scores indicate worse pain.
Patient satisfaction at 7 days
Patient-reported satisfaction one week after treatment will be measured using a 5-point Likert scale. The scale ranges from 1 (very dissatisfied) to 5 (very satisfied). Higher scores indicate better satisfaction.
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