Efficacy of combining a buccal infiltration with an inferior alveolar nerve block for mandibular molars with irreversible pulpitis.
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.
Parirokh
Masoud
M
Neuroscience Research Center, Oral and Dental Research Center, Kerman University of Medical Sciences, Kerman, Iran. masoudparirokh@yahoo.com
Satvati
Seyed Amir
SA
Sharifi
Rohollah
R
Rekabi
Ali Reza
AR
Gorjestani
Hedayat
H
Nakhaee
Nozar
N
Abbott
Paul V
PV
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
D000779:Anesthetics, Local; D004338:Drug Combinations; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine