Journal of conservative dentistry and endodontics · 2026
Comparative evaluation of supplemental buccal infiltration adjuncts for enhancing inferior alveolar nerve block in symptomatic irreversible pulpitis: A randomized double-blind clinical study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gupta Aakash, Singh Tarun Kumar, Gill Shagun, Kulshrestha Aditi, Dalai Sasmita
Аннотация
BACKGROUND: Achieving profound pulpal anesthesia in mandibular molars with symptomatic irreversible pulpitis remains challenging, with inferior alveolar nerve block (IANB) failure rates up to 80%. This study evaluated the effect of supplemental buccal infiltration using tramadol, dexamethasone, ketorolac, and temperature-modified lidocaine on the efficacy of IANB.
MATERIALS AND METHODS: In this randomized, double-blind clinical trial, 120 patients were allocated to six groups (n = 20 each): Control (IANB only), dexamethasone (4 mg/mL), ketorolac (30 mg/mL), tramadol (50 mg/mL), warm lidocaine (40°C), and cold lidocaine (4°C). All received 2% lidocaine with 1:200,000 epinephrine for IANB, followed by 1 mL of the assigned infiltration. Pain intensity was recorded using the Numeric Pain Rating Scale (0-10) during access, chamber, and canal entry. Anesthetic success was defined as a score <3 at canal entry.
RESULTS: Anesthetic success rates were 90% (95% confidence interval [CI], 68%-99%) for tramadol, and 85% (95% CI, 62%-97%) for cold lidocaine, significantly higher than control (40%, P = 0.001 and P = 0.002, respectively). Dexamethasone (55%), ketorolac (50%), and warm lidocaine (60%) showed nonsignificant improvement (P > 0.05). Median pain scores were significantly lower in the tramadol and cold lidocaine groups across all the stages (P < 0.001). No adverse events occurred.
CONCLUSION: Supplemental buccal infiltration with tramadol or cold lidocaine significantly enhances IANB success in mandibular molars with irreversible pulpitis, offering a simple, safe, and cost-effective approach to improve pulpal anesthesia.
MATERIALS AND METHODS: In this randomized, double-blind clinical trial, 120 patients were allocated to six groups (n = 20 each): Control (IANB only), dexamethasone (4 mg/mL), ketorolac (30 mg/mL), tramadol (50 mg/mL), warm lidocaine (40°C), and cold lidocaine (4°C). All received 2% lidocaine with 1:200,000 epinephrine for IANB, followed by 1 mL of the assigned infiltration. Pain intensity was recorded using the Numeric Pain Rating Scale (0-10) during access, chamber, and canal entry. Anesthetic success was defined as a score <3 at canal entry.
RESULTS: Anesthetic success rates were 90% (95% confidence interval [CI], 68%-99%) for tramadol, and 85% (95% CI, 62%-97%) for cold lidocaine, significantly higher than control (40%, P = 0.001 and P = 0.002, respectively). Dexamethasone (55%), ketorolac (50%), and warm lidocaine (60%) showed nonsignificant improvement (P > 0.05). Median pain scores were significantly lower in the tramadol and cold lidocaine groups across all the stages (P < 0.001). No adverse events occurred.
CONCLUSION: Supplemental buccal infiltration with tramadol or cold lidocaine significantly enhances IANB success in mandibular molars with irreversible pulpitis, offering a simple, safe, and cost-effective approach to improve pulpal anesthesia.