Frontiers in dental medicine · 2026
Evaluation of the effectiveness of local anesthesia approaches for symptomatic irreversible pulpitis: a systematic review and meta-analysis.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Li Xu, Chen Xin, Wang Qian, Gui Yuqing, Huang Fengqing, Zhong Dinghao, Xiong Lijun, Xiao Mengyan, Luo Zining, Gu Junxian, Xu Xinyu, Xie Jiebin
Аннотация
OBJECTIVE: This meta-analysis assessed the efficacy of various anesthetic protocols for symptomatic irreversible pulpitis, comparing techniques and agents to identify the optimal anesthesia approach.
METHODS: We conducted a comprehensive search of the Cochrane Library, PubMed, Web of Science, Scopus, and Embase databases up to July 10, 2025, identifying relevant studies based on predefined inclusion and exclusion criteria. The primary outcome was the success rate of anesthesia. Data extraction and quality assessment were performed using a pre-designed form and the revised Cochrane Risk of Bias Tool. A fixed-effect model was used for meta-analysis when heterogeneity was low (I 2 ≤ 50%, p ≥ 0.1); otherwise, a random-effects model was adopted. Additionally, another model was employed for validation, and the results from both models were compared to derive more reasonable conclusions. Publication bias was assessed using funnel plots and the Egger test.
RESULTS: Fourteen RCTs were included in the meta-analysis. Pooled analysis showed that modified anesthetic protocols for SIP were 3.62 times more successful than conventional inferior alveolar nerve block (IANB) using standard 2% lidocaine with epinephrine (OR = 3.34; 95% CI: 2.49-4.48). Studies conducted in Iran had the highest success rate (OR = 4.31; 95% CI: 3.59-5.17, p < 0.001). Inferior alveolar nerve block (IANB) was more effective than buccal infiltration (OR = 4.03; 95% CI: 3.38-4.81, p < 0.001), and 4% articaine demonstrated the highest efficacy (OR = 4.18; 95% CI: 2.85-6.16, p < 0.001).
CONCLUSION: This meta-analysis assessed the efficacy of various anesthetic protocols for SIP, comparing techniques and agents to identify the optimal anesthesia approach.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/recorddashboard, PROSPERO database CRD42025638427.
METHODS: We conducted a comprehensive search of the Cochrane Library, PubMed, Web of Science, Scopus, and Embase databases up to July 10, 2025, identifying relevant studies based on predefined inclusion and exclusion criteria. The primary outcome was the success rate of anesthesia. Data extraction and quality assessment were performed using a pre-designed form and the revised Cochrane Risk of Bias Tool. A fixed-effect model was used for meta-analysis when heterogeneity was low (I 2 ≤ 50%, p ≥ 0.1); otherwise, a random-effects model was adopted. Additionally, another model was employed for validation, and the results from both models were compared to derive more reasonable conclusions. Publication bias was assessed using funnel plots and the Egger test.
RESULTS: Fourteen RCTs were included in the meta-analysis. Pooled analysis showed that modified anesthetic protocols for SIP were 3.62 times more successful than conventional inferior alveolar nerve block (IANB) using standard 2% lidocaine with epinephrine (OR = 3.34; 95% CI: 2.49-4.48). Studies conducted in Iran had the highest success rate (OR = 4.31; 95% CI: 3.59-5.17, p < 0.001). Inferior alveolar nerve block (IANB) was more effective than buccal infiltration (OR = 4.03; 95% CI: 3.38-4.81, p < 0.001), and 4% articaine demonstrated the highest efficacy (OR = 4.18; 95% CI: 2.85-6.16, p < 0.001).
CONCLUSION: This meta-analysis assessed the efficacy of various anesthetic protocols for SIP, comparing techniques and agents to identify the optimal anesthesia approach.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/recorddashboard, PROSPERO database CRD42025638427.