title: Efficacy of combining a buccal infiltration with an inferior alveolar nerve block for mandibular molars with irreversible pulpitis.
abstract: OBJECTIVE
  The aim of this study was to assess the efficacy of inferior alveolar nerve (IAN) block combined with buccal infiltration for mandibular molars with irreversible pulpitis.
  
  
  METHODS
  Eighty-four patients were randomly assigned to 3 groups of 28 patients each. Lidocaine 2% with 1:80,000 epinephrine was used for all injections. Group I patients received an IAN block with 1.8 mL of anesthetic. Group II patients received an IAN block using 3.6 mL. Group III patients received 1.8 mL as an IAN block and 1.8 mL as a buccal infiltration. A visual analogue scale was used to rate pain before anesthesia and discomfort experienced before and during access cavity preparation. Data were analyzed by chi-square, ANOVA, Kruskal-Wallis, and Mann-Whitney tests.
  
  
  RESULTS
  The success rates for groups I to III were 14.8%, 39.3%, and 65.4%, respectively. Group III had significantly better anesthesia compared with group I (P < .05).
  
  
  CONCLUSIONS
  Combining an IAN block and a buccal infiltration injection provided more effective anesthesia in mandibular molars with irreversible pulpitis. However, some cases may still require further anesthesia to prevent pain during endodontic treatment.
authors.affiliation: Neuroscience Research Center, Oral and Dental Research Center, Kerman University of Medical Sciences, Kerman, Iran. masoudparirokh@yahoo.com
authors.forename: Masoud
authors.initials: M
authors.lastname: Parirokh
authors.forename: Seyed Amir
authors.initials: SA
authors.lastname: Satvati
authors.forename: Rohollah
authors.initials: R
authors.lastname: Sharifi
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Rekabi
authors.forename: Hedayat
authors.initials: H
authors.lastname: Gorjestani
authors.forename: Nozar
authors.initials: N
authors.lastname: Nakhaee
authors.forename: Paul V
authors.initials: PV
authors.lastname: Abbott
mesh_terms: D000278:Administration, Buccal; D000328:Adult; D000704:Analysis of Variance; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D004338:Drug Combinations; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008334:Mandible; D008340:Mandibular Nerve; D008963:Molar / Q000473:pathology / Q000601:surgery; D009407:Nerve Block / Q000379:methods; D010147:Pain Measurement; D011446:Prospective Studies; D011671:Pulpitis / Q000473:pathology / Q000601:surgery*; D012390:Root Canal Therapy; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D004338:Drug Combinations; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine