Anesthetic Efficacy of Inferior Alveolar Nerve Block Combined with Articaine Buccal Infiltration in Molars with Symptomatic Irreversible Pulpitis.

Objective: To determine the anesthetic effectiveness of inferior alveolar nerve block with 2% lidocaine and inferior alveolar nerve block with 2% lidocaine supplemented with 4% articaine buccal infiltration for the mandibular molars in non-surgical root canal treatment with symptomatic irreversible pulpitis.Methods: This prospective interventional comparative single-blind study was conducted at PNS Shifa Hospital, Karachi. Based on the non-probability convenience sampling, 88 adults aged 18-52 years old, with irreversible pulpitis of vital mandibular molars diagnosed as spontaneous lingering pain with positive cold pulp test, were randomly allocated to either Group A, who received IANB with 2% lidocaine alone or Group B received IANB with 2% lidocaine supplemented with 4% articaine buccalinfiltration. Heft Parker VAS Scale was used to report pain levels during the endodontic treatment. SPSS 27.00 software version was used to analyze the data.Results: Mean age in Group A was 35.6 ± 9.16 years, while in Group B it was 32.9 ± 10.54 years. Mean VAS pain score in Group A was 3.3 ± 2.68 compared to 3.0 ± 2.39 in Group B. There were 20 (45.5%) males and 24 (54.5%) females in Group A, and 30 (68.2%) males and 14 (31.8%) females in Group B. Pain severity in Group-A was no Pain 6 (13.6%), Mild Pain 21 (47.7%), Moderate Pain 11 (25.0%), and Severe Pain 6 (13.6%); in Group-B, No Pain 5 (11.4%), Mild Pain 28 (63.6%), ModeratePain 6 (13.6%), and Severe Pain 5 (11.4%). Treatment effectiveness was achieved in 28 (63.6%) patients in Group A and 33 (75.0%) in Group B.Conclusion: The combined approach of IANB with 2% lidocaine supplemented with 4% articaine buccal infiltration had significantly improved the anesthetic success outcome as compared to the 2% lidocaine alone for IANB.