title: A prospective, randomized, single-blind comparative evaluation of anesthetic efficacy of posterior superior alveolar nerve blocks, buccal infiltrations, and buccal plus palatal infiltrations in patients with irreversible pulpitis.
abstract: BACKGROUND
  The purpose of this study was to evaluate and compare the anesthetic efficacy of posterior superior alveolar (PSA) nerve blocks, buccal infiltrations, and buccal plus palatal infiltrations with 2% lidocaine with 1:200,000 epinephrine in maxillary first molars with irreversible pulpitis.
  
  
  METHODS
  Ninety-four adult patients participated in this prospective, randomized, single-blinded study. The patients were divided into 3 treatment groups on a random basis. Twenty-eight patients received a PSA nerve block, 33 patients received buccal infiltrations, and 33 patients received buccal plus palatal infiltrations with 2% lidocaine with 1:200,000 epinephrine. Endodontic access preparation was initiated 15 minutes after injection. Pain during treatment was recorded using a Heft-Parker visual analog scale. Success was recorded as "none" or "mild" pain.
  
  
  RESULTS
  Statistical analysis using nonparametric chi-square tests revealed that there was no statistical difference between the anesthetic success of PSA nerve blocks (64%), buccal infiltrations (54%), and buccal plus palatal infiltrations (70%).
  
  
  CONCLUSIONS
  None of the tested methods gave 100% anesthetic success rates in maxillary first molars with irreversible pulpitis.
authors: Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India. drvivekaggarwal@gmail.com
authors: Vivek
authors: V
authors: Aggarwal
authors: Mamta
authors: M
authors: Singla
authors: Sanjay
authors: S
authors: Miglani
authors: Irfan
authors: I
authors: Ansari
authors: Sarita
authors: S
authors: Kohli
mesh_terms: D000278:Administration, Buccal; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008442:Maxillary Nerve; D008963:Molar; D009407:Nerve Block; D010147:Pain Measurement; D021362:Palate, Hard; D011446:Prospective Studies; D011671:Pulpitis / Q000628:therapy*; D016037:Single-Blind Method; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine