Comparison of the success rate of two anesthetic techniques using lidocain 2% in mandibular secondary premolars with symptomatic irreversible pulpitis: Randomized controlled clinical trial

Abstract

Aim: The purpose of this study was to compare the effectiveness of inferior alveolar nerve block (IANB) and the combination of buccal infiltrations and periodontal ligament injection as a primary injection for providing anaesthesia to mandibular premolars with symptomatic irreversible pulpitis. Materials and Methods: This randomised clinical trial included eighty patients diagnosed with symptomatic irreversible pulpitis in mandibular second premolars. Patients were randomly divided into two treatment groups (N = 40) according to the administered technique: Group 1 (IANB): standard inferior alveolar nerve block (IANB) injection by 1.8 mL of lidocaine 2%; Group 2 (BI + PDL): buccal infiltration (0.9 ml of carpool) followed by periodontal ligament injection (0.9 ml of carpool) after 5 minutes. Patients rated pain intensity using a visual rating scale (VAS) during access preparation and entering the pulp chamber. Statistical analysis was performed using an independent T-test and Mann-Whitney U test. The level of statistical significance was set at 0.05. Results: The patients receiving IANB injections had a success rate of 53.85 %, whereas buccal infiltration followed by intraligamentary injection was successful in 77.78 % of cases (P-value = 0.01). No significant difference was between the two injections during access preparation and entering the pulp chamber (P-value > 0.05). However, there was a statistically higher pain during canal instrumentation when the IANB technique was used (P-value = 0.032). Conclusion: Considering the limitations of this study, we concluded that buccal infiltration followed by intraligamentary injection could be employed to achieve successful anaesthesia during the endodontic management of mandibular premolars with irreversible pulpitis.