Anesthetic Efficacy Of Inferior Alveolar Nerve Block,Infiltration Injection,and Supplemental Periodontal Ligament Injection In Mandibular Posterior Teeth

Objective This study was aim to compare the anesthetic efficacy of inferior alveolar nerv e block(IANB),infiltration injection,and supplemental articaine periodontal liga ment injection after a failed primary anesthesia,in first and second molars and premolars in patients presenting with irreversible pulpitis.MethodsIn this prospective,randomized single-blind study,130 collected subjects with posterior teeth irreversible pulpitis who were treated in the Stomatological Hospital of Shandong University from February 2016 to April 2017 were divided into two groups(A/B)randomly.65 patients(A)received IANB containing 4ml 2%lidocaine and the other 65 patients(B)received buccal and lingual infiltration injections containing 1.7ml 4%articaine.Each patient were asked to record their pain using a visual analog scale(VAS)before commencing treatment following cold and hot test.During the endodontic access and 15min after the designated anesthetic injection,the VAS value was recorded,too.If the patient felt moderate to severe pain,a supplemental intraligamentary injection of 4%articaine with 1:100.000 epinephrine was administered,and endodontic treatment continued.No or mild pain at any stage was considered a success,compare the success rate of anesthesia in two groups.All the data were processed by SPSS22.0.ResultsBefore supplemental intraligamentary injection,the success rate of anesthesia in group A:the first molars=44.4%.the second molars=38.9%,premolars=45.5%;in group B:the first molars=47.6%.the second molars=39.3%,premolars=87.5%.After supplemental intraligamentary injection,the success rate of anesthesia in group A:the first molars=83.3%.the second molars=91.7%,premolars=100%;in group B:the first molars=90.5%.the second molars=92.9%,premolars=100%.No significant difference was found when a single injection was compared between groups in molars(p>0.05),but the success rate of group B was higher than group A in premolars(p<0.05).There was no significant difference between molars and premolars in group A(p>0.05).but he success rate of premolars was higher than molars in group B(p<0.05).After supplemental intraligamentary injection,there was no significant difference between two groups in molars and premolars(p>0.05).But after supplemental intraligamentary injection,the success rate of anesthesia was significantly higher than single anesthesia for molars(p<0.05).ConclusionTwo methods can get similar success rate in patients presenting with irreversible pulpitis for molars.Buccal and lingual infiltration injection was better for premolars,Buccal and lingual infiltration injection for premolars was better than molars.Supplemental intraligamentary injection can improve the success rate of anesthesia for molars.