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Clinical Oral Investigations

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01-03-2020 | Nerve Block | Original Article

The efficacy of supplemental intraseptal and buccal infiltration anesthesia in mandibular molars of patients with symptomatic irreversible pulpitis

Authors: Omid Dianat, Mohamad Ali Mozayeni, Mohammad Karim Layeghnejad, Shiva Shojaeian

Published in: Clinical Oral Investigations | Issue 3/2020

Abstract

Objective

The aim of this randomized clinical trial was to compare the success rate of three different anesthetic techniques in mandibular molars with symptomatic irreversible pulpitis.

Materials and methods

Ninety patients with symptomatic irreversible pulpitis in mandibular molars randomly received three anesthetic techniques. Group I: an inferior alveolar nerve block (IANB) of 2% lidocaine. Group II: IANB and buccal infiltration (BI) of 4% articaine. Group III: IANB + BI and intraseptal injection of articaine in each mesial and distal papilla. The pain (Heft-Parker visual analog scale (VAS)) and electric pulp tester (EPT) scores were recorded prior to (VAS1, EPT1) and after the injection and during access preparation (VAS2, EPT2). The success of anesthesia was defined as the ability to access the tooth with no or mild pain (VAS ≤ 54).

Results

The mean value for VAS2 was significantly less and the mean value for EPT2 was significantly more in groups II and III compared with group I. The success rates for groups I, II, and III were 30.33%, 66.66%, and 80.00% respectively. Also, differences of EPT2, VAS2, and success rates were statistically significant between groups II and III.

Conclusion

Administration of articaine as a supplemental intraseptal and BI following IANB can be considered a more successful anesthetic technique in mandibular molars with symptomatic irreversible pulpitis compared with the conventional IANB and supplemental BI.

Clinical relevance

The addition of an articaine intraseptal injection to IANB+BI technique may result in a significantly higher success rate of pulpal anesthesia in mandibular molars with symptomatic irreversible pulpitis.

Claffey E, Reader A, Nusstein J, Beck M, Weaver J (2004) Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis. J Endod 30:568–571CrossRef

Cohen HP, Cha BY, Spangberg LS (1993) Endodontic anesthesia in mandibular molars: a clinical study. J Endod 19:370–373. https://doi.org/10.1016/s0099-2399(06)81366-x CrossRefPubMed

Kennedy S, Reader A, Nusstein J, Beck M, Weaver J (2003) The significance of needle deflection in success of the inferior alveolar nerve block in patients with irreversible pulpitis. J Endod 29:630–633. https://doi.org/10.1097/00004770-200310000-00004 CrossRefPubMed

Corbella S, Taschieri S, Mannocci F, Rosen E, Tsesis I, Del Fabbro M (2017) Inferior alveolar nerve block for the treatment of teeth presenting with irreversible pulpitis: a systematic review of the literature and meta-analysis. Quintessence Int 48:69–82. https://doi.org/10.3290/j.qi.a37131 CrossRefPubMed

Kreimer T, Kiser R 2nd, Reader A, Nusstein J, Drum M, Beck M (2012) Anesthetic efficacy of combinations of 0.5 mol/L mannitol and lidocaine with epinephrine for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis. J Endod 38:598–603. https://doi.org/10.1016/j.joen.2012.02.016 CrossRefPubMed

Parirokh M, Satvati SA, Sharifi R, Rekabi AR, Gorjestani H, Nakhaee N, Abbott PV (2010) Efficacy of combining a buccal infiltration with an inferior alveolar nerve block for mandibular molars with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109:468–473. https://doi.org/10.1016/j.tripleo.2009.11.016 CrossRefPubMed

Saatchi M, Farhad AR, Shenasa N, Haghighi SK (2016) Effect of sodium bicarbonate buccal infiltration on the success of inferior alveolar nerve block in mandibular first molars with symptomatic irreversible pulpitis: a prospective, randomized double-blind study. J Endod 42:1458–1461. https://doi.org/10.1016/j.joen.2016.07.004 CrossRefPubMed

Fowler S, Drum M, Reader A, Beck M (2016) Anesthetic success of an inferior alveolar nerve block and supplemental articaine buccal infiltration for molars and premolars in patients with symptomatic irreversible pulpitis. J Endod 42:390–392. https://doi.org/10.1016/j.joen.2015.12.025 CrossRefPubMed

Haase A, Reader A, Nusstein J, Beck M, Drum M (2008) Comparing anesthetic efficacy of articaine versus lidocaine as a supplemental buccal infiltration of the mandibular first molar after an inferior alveolar nerve block. J Am Dent Assoc 139:1228–1235CrossRef

10.

Malamed SF (2014) Handbook of local anesthesia-e-book. Elsevier Health Sciences, St. Louis

11.

Woodmansey K (2005) Intraseptal anesthesia: a review of a relevant injection technique. Gen Dent 53:418–420PubMed

12.

Brkovic BM, Savic M, Andric M, Jurisic M, Todorovic L (2010) Intraseptal vs. periodontal ligament anaesthesia for maxillary tooth extraction: quality of local anaesthesia and haemodynamic response. Clin Oral Investig 14:675–681. https://doi.org/10.1007/s00784-009-0352-7 CrossRefPubMed

13.

Saadoun AP, Malamed S (1985) Intraseptal anesthesia in periodontal surgery. J Am Dent Assoc 111:249–256CrossRef

14.

Webster S Jr, Drum M, Reader A, Fowler S, Nusstein J, Beck M (2016) How effective is supplemental intraseptal anesthesia in patients with symptomatic irreversible pulpitis? J Endod 42:1453–1457. https://doi.org/10.1016/j.joen.2016.07.002 CrossRefPubMed

15.

Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13:227–236CrossRef

16.

Certosimo AJ, Archer RD (1996) A clinical evaluation of the electric pulp tester as an indicator of local anesthesia. Oper Dent 21:25–30PubMed

17.

Modaresi J, Mozayeni MA, Dianat O (2005) Comparing the quality of anaesthesia in normal and inflamed teeth by pulp testing. Aust Endod J 31:120–122CrossRef

18.

Kung J, McDonagh M, Sedgley CM (2015) Does articaine provide an advantage over lidocaine in patients with symptomatic irreversible pulpitis? A systematic review and meta-analysis. J Endod 41:1784–1794. https://doi.org/10.1016/j.joen.2015.07.001 CrossRefPubMed

19.

Hosseini HR, Parirokh M, Nakhaee N, Abbott PV, Samani S (2016) Efficacy of articaine and lidocaine for buccal infiltration of first maxillary molars with symptomatic irreversible pulpitis: a randomized double-blinded clinical trial. Iran Endod J 11:79–84. https://doi.org/10.7508/iej.2016.02.001 CrossRefPubMedPubMedCentral

20.

Ashraf H, Kazem M, Dianat O, Noghrehkar F (2013) Efficacy of articaine versus lidocaine in block and infiltration anesthesia administered in teeth with irreversible pulpitis: a prospective, randomized, double-blind study. J Endod 39:6–10. https://doi.org/10.1016/j.joen.2012.10.012 CrossRefPubMed

21.

Matthews R, Drum M, Reader A, Nusstein J, Beck M (2009) Articaine for supplemental buccal mandibular infiltration anesthesia in patients with irreversible pulpitis when the inferior alveolar nerve block fails. J Endod 35:343–346. https://doi.org/10.1016/j.joen.2008.11.025 CrossRefPubMed

22.

Aggarwal V, Singla M, Rizvi A, Miglani S (2011) Comparative evaluation of local infiltration of articaine, articaine plus ketorolac, and dexamethasone on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis. J Endod 37:445–449. https://doi.org/10.1016/j.joen.2011.01.016 CrossRefPubMed

23.

Singla M, Subbiya A, Aggarwal V, Vivekanandhan P, Yadav S, Yadav H, Venkatesh A, Geethapriya N, Sharma V (2015) Comparison of the anaesthetic efficacy of different volumes of 4% articaine (1.8 and 3.6 mL) as supplemental buccal infiltration after failed inferior alveolar nerve block. Int Endod J 48:103–108. https://doi.org/10.1111/iej.12283 CrossRefPubMed

24.

Rogers BS, Botero TM, McDonald NJ, Gardner RJ, Peters MC (2014) Efficacy of articaine versus lidocaine as a supplemental buccal infiltration in mandibular molars with irreversible pulpitis: a prospective, randomized, double-blind study. J Endod 40:753–758. https://doi.org/10.1016/j.joen.2013.12.022 CrossRefPubMed

25.

Tortamano IP, Siviero M, Lee S, Sampaio RM, Simone JL, Rocha RG (2013) Onset and duration period of pulpal anesthesia of articaine and lidocaine in inferior alveolar nerve block. Braz Dent J 24:371–374. https://doi.org/10.1590/0103-6440201302072 CrossRefPubMed

26.

Aggarwal V, Jain A, Kabi D (2009) Anesthetic efficacy of supplemental buccal and lingual infiltrations of articaine and lidocaine after an inferior alveolar nerve block in patients with irreversible pulpitis. J Endod 35:925–929. https://doi.org/10.1016/j.joen.2009.04.012 CrossRefPubMed

27.

Kanaa MD, Whitworth JM, Meechan JG (2012) A prospective randomized trial of different supplementary local anesthetic techniques after failure of inferior alveolar nerve block in patients with irreversible pulpitis in mandibular teeth. J Endod 38:421–425. https://doi.org/10.1016/j.joen.2011.12.006 CrossRefPubMed

28.

Kanaa MD, Whitworth JM, Corbett IP, Meechan JG (2006) Articaine and lidocaine mandibular buccal infiltration anesthesia: a prospective randomized double-blind cross-over study. J Endod 32:296–298. https://doi.org/10.1016/j.joen.2005.09.016 CrossRefPubMed

29.

Bonar T, Nusstein J, Reader A, Drum M, Fowler S, Beck M (2017) Anesthetic efficacy of articaine and lidocaine in a primary intraseptal injection: a prospective, randomized double-blind study. Anesth Prog 64:203–211. https://doi.org/10.2344/anpr-64-04-10 CrossRefPubMedPubMedCentral

30.

Biocanin V, Brkovic B, Milicic B, Stojic D (2013) Efficacy and safety of intraseptal and periodontal ligament anesthesia achieved by computer-controlled articaine + epinephrine delivery: a dose-finding study. Clin Oral Investig 17:525–533. https://doi.org/10.1007/s00784-012-0724-2 CrossRefPubMed

Title: The efficacy of supplemental intraseptal and buccal infiltration anesthesia in mandibular molars of patients with symptomatic irreversible pulpitis
Authors: Omid Dianat
Mohamad Ali Mozayeni
Mohammad Karim Layeghnejad
Shiva Shojaeian
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keyword: Nerve Block
Published in: Clinical Oral Investigations / Issue 3/2020
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-03006-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The efficacy of supplemental intraseptal and buccal infiltration anesthesia in mandibular molars of patients with symptomatic irreversible pulpitis

Abstract

Objective

Materials and methods

Results

Conclusion

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

Clinical relevance

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