Evulation of the effectiveness of anesthesia applied to the mental foramen or mandibular foramen before root canal treatment of mandibular premolar teeth with pulpitis using a visual analog scale

This study aimed to compare the effectiveness of mental nerve block (MINB) and conventional inferior alveolar nerve block (IANB) anesthesia during endodontic treatment of mandibular I. and II. premolars with symptomatic irreversible pulpitis. This randomized, single-blind, prospective clinical trial included 120 patients (52 males, 68 females) from 273 candidates for endodontic treatment of mandibular premolars. Patients were assigned to two groups: IANB (n=60; 28 first premolars, 32 second premolars) and MINB (n=60; 26 first premolars, 34 second premolars) based on randomization. Pain was assessed preoperatively and during cold tests, cavity preparation, and pulp extirpation using the Numerical Rating Scale (NRS) from 0 to 10. Statistical analyses were conducted using the Independent t-test, Chi-square test, and Mann-Whitney U test (α=0.05). The success rate in IANB and MINB anesthesia groups was statistically similar. Both anesthesia techniques showed a success rate of 70% (χ 2 (1)<0.001 and p=1.000). IANB showed no difference with a success rate of 71.4% in first premolars and 68.8% in second premolars (p=0.143). For MINB anesthesia, it showed a success rate of 76.9% in first premolars and 64.7% in second premolars and the difference between the two groups was statistically significant (p=0.012). MINB was found to be equally effective as the conventional IANB in providing anesthesia for mandibular premolars during routine endodontic procedures. Both techniques were found to offer comparable pain control. However, MINB was observed to be less effective for second premolars compared to first premolars. The findings suggest that, despite the comparable success rates of both anesthesia techniques, supplemental anesthesia may still be required to achieve adequate pain management for mandibular premolars.