Prevalence of Failed Inferior Alveolar Nerve Block (IANB) in Achieving Pulpal Anaesthesia in Mandibular Molars with Symptomatic Irreversible Pulpitis

Document Type : Original Article

Authors

1 Assistant Professor, Department of Endodontics, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia

2 Assistant Professor, Oral and Maxillofacial Rehabilitation Department, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia

Abstract

Introduction: Patient comfort during root canal treatment is immense for patient cooperation and endodontist efficiency. Establishing the high prevalence of failure of IANB injections in providing pulpal anaesthesia, will most likely support the investigation of supplemental techniques to ensure patient comfort.
Objectives: The study aimed to evaluate the prevalence of failed Inferior Alveolar Nerve Block (IANB) injections in achieving pulpal anaesthesia in mandibular molars diagnosed with symptomatic irreversible pulpitis when administered alone.
Methods: This study involved fifty patients, diagnosed with symptomatic irreversible pulpitis in their mandibular first and second molars. IANB injection using 2% lidocaine with 1:100,000 epinephrine was administered to anesthetize the acutely inflamed teeth before commencing root canal treatment. Lip and tongue numbness was checked subjectively after injection to ensure successful IANB injection. Objectively, cold test was performed after 15 minutes and pain level was recorded using Visual Analogue Scale (VAS). Success was defined as no pain response by (VAS) during cavity preparation, endodontic access, or initial instrumentation.
Results: Although, majority of patient (96%) expressed surrounding soft tissue numbness, only 73% did not feel any pain during initiating root canal treatment.
Conclusions: IANB injection alone is not enough to provide profound pulpal anaesthesia in acutely inflamed mandibular molars; therefore, supplemental injections are required to achieve patients comfort during treatment.

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