title: Anesthetic efficacy of the supplemental X-tip intraosseous injection using 4% articaine with 1:100,000 adrenaline in patients with irreversible pulpitis: An in vivo study.
abstract: BACKGROUND
  Pain management remains the utmost important qualifying criteria in minimizing patient agony and establishing a strong dentist-patient rapport. Symptomatic irreversible pulpitis is a painful condition necessitating immediate attention and supplemental anesthetic techniques are often resorted to in addition to conventional inferior alveolar nerve block.
  
  
  OBJECTIVE
  The purpose of the study was to evaluate the anesthetic efficacy of X-tip intraosseous injection in patients with symptomatic irreversible pulpitis, in mandibular posterior teeth, using 4% Articaine with 1:100,000 adrenaline as local anesthetic, when the conventional inferior alveolar nerve block proved ineffective.
  
  
  METHODS
  X-tip system was used to administer 1.7 ml of 4% articaine with 1:100,000 adrenaline in 30 patients diagnosed with irreversible pulpitis of mandibular posterior teeth with moderate to severe pain on endodontic access after administration of an inferior alveolar nerve block.
  
  
  RESULTS
  The results of the study showed that 25 X-tip injections (83.33%) were successful and 5 X-tip injections (16.66%) were unsuccessful.
  
  
  CONCLUSIONS
  When the inferior alveolar nerve block fails to provide adequate pulpal anesthesia, X-tip system using 4% articaine with 1:100,000 adrenaline was successful in achieving pulpal anesthesia in patients with irreversible pulpitis.
authors.affiliation: Department of Conservative Dentistry and Endodontics, Regional Dental College, Bhangagarh, Guwahati, Assam, India.
authors.forename: Atool Chandra
authors.initials: AC
authors.lastname: Bhuyan
authors.affiliation: Department of Conservative Dentistry and Endodontics, Regional Dental College, Bhangagarh, Guwahati, Assam, India.
authors.forename: Satheesh Sasidharan
authors.initials: SS
authors.lastname: Latha
authors.affiliation: Department of Conservative Dentistry and Endodontics, Regional Dental College, Bhangagarh, Guwahati, Assam, India.
authors.forename: Shefali
authors.initials: S
authors.lastname: Jain
authors.affiliation: Department of Conservative Dentistry and Endodontics, Regional Dental College, Bhangagarh, Guwahati, Assam, India.
authors.forename: Rubi
authors.initials: R
authors.lastname: Kataki
keywords: Articaine; X-tip; inferior alveolar nerve block; intraosseous anesthesia