Evaluation of the effectiveness of different anesthesia methods for pulpal anesthesia in the lower jaw

The aim of root canal treatment is to fill the root canal system after adequate preparation and disinfection. An adequate depth of anesthesia is critical in this treatment. IANB is routinely used when root canal treatment is required in mandibular posterior teeth. In mandibular molar teeth with irreversible pulpitis, predictable depth of anesthesia is not guarenteed with IANB. In such cases, supplemental anesthesia methods such as intraosseous, buccal infiltration anesthesia are required. The aim of this study is to retrospectively evaluate the effectiveness of different anesthesia methods in the mandible. Forty patients that has mandibular molars diagnosed with irreversible pulpitis were included to our study. All patients underwent IANB with 2% lidocaine 1:100,000, patients who still felt pain during the treatment divided into 4 groups; second dose of IANB, buccal infiltration with articaine, mylohyoid anesthesia and intraosseous anesthesia. After the supplemental anesthesia access cavity was completed, the patients were asked to report their pain using HP-VAS. After the treatment, postoperative pain of the patients were measured with VAS at the 6th hour, 12th hour, 24th hour, 48th hour and 7th day. As a result of statistical analysis, no significant difference was found between supplemental anesthesia methods, and success rates were %60, %60, %70, %80 respectively. There was no significant difference between the groups in terms of postoperative pain. There was a significant decrease in pain levels after 24 hours in all groups. Postoperative pain was found to be related to the time elapsed after treatment rather than the anesthetic method.