Evaluation of the efficiency of intraligamentary + buccal infiltration anesthesia and inferior alveolar nerve block + buccal infiltration anesthesia in symptomatic mandibular molars with irreversible pulpitis

The aim of this clinical study is to evaluate the success of buccal infiltration anesthesia + intraligamenter anesthesia between inferior alveolar nerve block anesthesia + buccal infiltration anesthesia in mandibular molar teeth with acute symptomatic irreversible pulpitis, for which endodontic treatment is planned. A total of 50 patients, aged between 18-65, who were diagnosed with symptomatic irreversible pulpitis of the mandibular molar tooth, were included in this study. The patients were allocated in two groups according to the randomization blocks, with a total of 25 patients in each group. In IASB + BI anesthesia techniques, a total of approximately 2.8 ml of anesthetic solution, 1.8 ml + 1 ml, was applied, while for BI + ILI, a total of approximately 1.72 ml, 1 ml + 0.72 ml, was administered. After the anesthesia, a rubber dam was placed on the associated tooth of the patient for root canal treatment, the endodontic access cavity was opened, and canal preparation procedures were started. The pain levels felt by the patients during the endodontic treatment stages (starting the treatment, opening the endodontic access cavity and pulp extirpation) were determined by Heft-Parker VAS scale. Anesthesia was considered successful in patients who felt no pain (HP-VAS ratio = 0) or mild pain (HP-VAS ratio ≤ 54) during the procedures. Chi-square and Shapiro-Wilk tests were used to compare data between groups. Generalized Estimating Equations (GEE) method was used to examine the change in VAS values during follow-up and to determine the features that affect this change. IBM SPSS Statistics Version 20.0 package program was used for statistical analysis of the data. Statistical significance level was taken as 0.05 in all tests. As a result of the study, anesthetic success rates for the IASB + BI and BI + ILI groups were determined as 44% and 36%, respectively. The difference between the groups was not statistically significant (p>0.05). Within the limitations of the study; BI + ILI as an anesthetic method in mandibular molar teeth with symptomatic irreversible pulpitis can be an alternative to IASB + BI anesthesia.