title: Efficacy of single buccal infiltrations for maxillary first molars in patients with irreversible pulpitis: a randomized controlled clinical trial.
abstract: OBJECTIVE
  To evaluate the efficacy of a single buccal infitration using 4% articaine hydrochloride (HCl) with 1 : 100,000 epinephrine or 4% articaine HCl with 1 : 100 000 epinephrine bitartrate for obtaining adequate pulpal anaesthesia in the palatal roots of maxillary first molars associated with irreversible pulpitis.
  
  
  METHODS
  In this single-blind randomized clinical trial, fifty subjects were randomly allocated to receive maxillary buccal injections of 1.5 mL 4% articaine with 1 : 100,000 epinephrine (n = 25) or 1.5 mL 4% articaine with 1 : 100,000 epinephrine bitartrate (n = 25). Visual analogue scale (VAS) scores and pulse rate measurements were recorded during access cavity preparation and initial file placement into the mesiobuccal, distobuccal and palatal canals. Data were analysed using Duncan and t-tests.
  
  
  RESULTS
  There was no significant difference between the two anaesthetic solutions regarding the VAS scores and pulse rate measurements during endodontic procedures. The mean VAS ratings of the 50 patients during file placement into the palatal canals were significantly higher compared with the other three root canal procedures (P < 0.0001). The heart rates during negotiation of palatal canals were significantly higher than when negotiating the mesiobuccal and distobuccal canals (P < 0.0001).
  
  
  CONCLUSIONS
  Single buccal infiltration did not achieve adequate pulpal anaesthesia in the palatal root canal of the maxillary first molars associated with irreversible pulpitis.
authors: Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.
authors: Ö İ
authors: Öİ
authors: Atasoy Ulusoy
authors: T
authors: T
authors: Alaçam
mesh_terms: D000278:Administration, Buccal; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002355:Carticaine / Q000008:administration & dosage*; D003782:Dental Pulp / Q000187:drug effects; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008437:Maxilla; D008963:Molar; D010147:Pain Measurement; D011671:Pulpitis / Q000628:therapy*; D012390:Root Canal Therapy / Q000379:methods*; D016037:Single-Blind Method; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002355:Carticaine; D004837:Epinephrine
keywords: anaesthetic success; articaine; infiltration anaesthesia; irreversible pulpitis; root canal