title: The success rate of bupivacaine and lidocaine as anesthetic agents in inferior alveolar nerve block in teeth with irreversible pulpitis without spontaneous pain.
abstract: OBJECTIVE
  Achieving adequate anesthesia with inferior alveolar nerve blocks (IANB) is of great importance during dental procedures. The aim of the present study was to assess the success rate of two anesthetic agents (bupivacaine and lidocaine) for IANB when treating teeth with irreversible pulpitis.
  
  
  METHODS
  Sixty volunteer male and female patients who required root canal treatment of a mandibular molar due to caries participated in the present study. The inclusion criteria included prolonged pain to thermal stimulus but no spontaneous pain. The patients were randomly allocated to receive either 2% lidocaine with 1:80,000 epinephrine or 0.5% bupivacaine with 1:200,000 epinephrine as an IANB injection. The sensitivity of the teeth to a cold test as well as the amount of pain during access cavity preparation and root canal instrumentation were recorded. Results were statistically analyzed with the Chi-Square and Fischer's exact tests.
  
  
  RESULTS
  At the final step, fifty-nine patients were included in the study. The success rate for bupivacaine and lidocaine groups were 20.0% and 24.1%, respectively. There was no significant difference between the two groups at any stage of the treatment procedure.
  
  
  CONCLUSIONS
  There was no difference in success rates of anesthesia when bupivacaine and lidocaine were used for IANB injections to treat mandibular molar teeth with irreversible pulpitis. Neither agent was able to completely anesthetize the teeth effectively. Therefore, practitioners should be prepared to administer supplemental anesthesia to overcome pain during root canal treatment.
authors.affiliation: Oral and Dental Diseases Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Masoud
authors.identifier: 0000-0003-0370-4997
authors.initials: M
authors.lastname: Parirokh
authors.affiliation: Endodontic Department, School of Dentistry, Yazd University of Medical Sciences, Yazd, Iran.
authors.forename: Mohammad Hosein
authors.initials: MH
authors.lastname: Yosefi
authors.affiliation: Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Nouzar
authors.initials: N
authors.lastname: Nakhaee
authors.affiliation: School of Dentistry, University of Western Australia, Perth, Australia.
authors.forename: Paul V
authors.identifier: 0000-0001-5727-4211
authors.initials: PV
authors.lastname: Abbott
authors.affiliation: Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Hamed
authors.identifier: 0000-0003-2899-3262
authors.initials: H
authors.lastname: Manochehrifar
keywords: Anesthesia; Bupivacaine; Cold test; Inferior alveolar nerve block; Irreversible pulpitis; Lidocaine