Comparative Evaluation of 1.8 mL and 3.6 mL of 2% Lidocaine with 1:200,000 Epinephrine for Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis: A Prospective, Randomized Single-blind Study

A Comparison of Different Volumes of Articaine for Inferior Alveolar Nerve Block for Molar Teeth with Symptomatic Irreversible Pulpitis

“…Conflicting results regarding IANB anesthesia success have been reported after the use of different volumes of anesthetic agents (20)(21)(22)(23)(24)(25)27). Most investigations have reported no significant difference in the success rate of IANB anesthesia with higher volumes of lidocaine (20)(21)(22)(23)25).…”

“…Most investigations have reported no significant difference in the success rate of IANB anesthesia with higher volumes of lidocaine (20)(21)(22)(23)25). In contrast, 2 studies have reported significantly higher success rates when the volume of lidocaine was increased for IANB injections (24,27). Some of the previous studies regarding different volumes of anesthetic solutions for IANBs have evaluated teeth with healthy pulps (20,21,23,27), whereas some others have tested different volumes of lidocaine in teeth with irreversible pulpitis (22,24,25).…”

“…Successful pulp anesthesia success is only achieved if no or minimal pain is reported by the patient during access cavity preparation and root canal instrumentation (9). One of the suggested methods to overcome the failure of anesthesia after the administration of an IANB is to increase the volume of the anesthetic solution (20)(21)(22)(23)(24)(25). Most of the previous investigations have reported that increasing the volume has no significant effect on anesthesia success.…”

Articaine in Endodontics: A Review.

“…55 One of the suggested methods to overcome the failure of anesthesia after the administration of an IANB is to increase the volume of the anesthetic solution. [56][57][58][59][60][61] Most of the previous investigations have reported that increasing the volume has no significant effect on anesthesia success. However, these studies have only used lidocaine as the anesthetic solution.…”

“…However, these studies have only used lidocaine as the anesthetic solution. [56][57][58][59][60][61][62][63][64][65][66][67][68]61 Irreversible pulpits , which is a severe damage to the pulp via bacteria in the vital dental pulp, would cause necrosis or death to pulp tissues, and thus leads to very intolerable severe spontaneous pain and forces patients to seek immediate treatment 62 articaine was the second most used dental local anesthetic in the US, only after lidocaine. 63 Articaine is generally effective in providing patients with pain-free treatment because of its high liposolubility which facilitates the diffusion of the anesthetic solution to the teeth, but local anesthetic failure is still a concern in treatment of irreversible pulpitis.…”