Anesthetic efficacy of mental/incisive nerve block compared to inferior alveolar nerve block using 4% articaine in mandibular premolars with symptomatic irreversible pulpitis: a randomized clinical trial
Original Article
First Online: 07 June 2018
Abstract
Objectives
The
aim of this study was to compare the onset, success rate, injection
pain, and post-injection pain of mental/incisive nerve block (MINB) with
that of inferior alveolar nerve block (IANB) using 4% articaine in
mandibular premolars with symptomatic irreversible pulpitis. The
accuracy of electrical pulp test (EPT) in determining pulpal anesthesia
was also examined.
Materials and methods
The
study was designed as a randomized clinical trial with two study
arms—MINB and IANB. Injections were performed using a standardized
technique. Root canal treatment was initiated 10 min after the
injection. Success was defined as no pain or mild pain during access
cavity preparation and instrumentation. Injection pain and
post-injection pain (up to 7 days) were recorded. All pain ratings were
done using Heft-Parker Visual Analog Scale (HP VAS).
Results
Sixty-four
patients were enrolled. The success rate of MINB (93.8%) was higher
than IANB (81.2%) but the difference was not significant (p > 0.05). The onset of anesthesia with MINB was significantly quicker, and injection pain was significantly less (p < 0.05), but post-injection pain was significantly higher during the first 4 days (p < 0.001). The accuracy of EPT in determining pulpal anesthesia was 96.88%.
Conclusions
MINB
and IANB with 4% articaine had similar efficacy in anesthetizing
mandibular premolars with irreversible pulpitis. Post-injection pain
with MINB was higher than with IANB.
Clinical relevance
MINB and IANB with 4% articaine can be used interchangeably to anesthetize mandibular premolars with irreversible pulpitis.
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