Comparing intraosseous computerized anaesthesia with inferior alveolar nerve block in the treatment of symptomatic irreversible pulpitis: A randomized controlled trial

Int Endod J. 2023 Aug;56(8):922-931. doi: 10.1111/iej.13935. Epub 2023 May 29.

Abstract

Aim: The aim of this study was to compare the cardiovascular effects [heart rate, oxygen saturation (SpO2 ), systolic and diastolic blood pressure] and the anaesthetic efficacy of intraosseous computerized anaesthesia (ICA) versus inferior alveolar nerve block (IANB) in Symptomatic irreversible pulpitis (SIP).

Methodology: The study protocol was registered with ClinicalTrials.gov (NCT03802305). In a randomized, prospective clinical trial, 72 mandibular molar teeth with SIP were randomly allocated to conventional IANB injection (n = 36) or ICA injection (n = 36), both with 1.8 mL of 4% articaine with 1:100 000 epinephrine. The primary objective was to assess the cardiovascular parameters (heart rate, oxygen saturation, blood pressure) before, during and after the anaesthesia. The secondary objectives were to compare ICA with IANB for success and postoperative outcomes for up to 3 days.

Results: The maximum increase in heart rate in the ICA group was greater than in the IANB. Other cardiovascular parameters did not show differences throughout the clinical procedure. There were no statistically significant differences (p > .05) between groups for sex, age, or anxiety. The total success rate of ICA (91.43%) was significantly higher (p = .0034) than that of IANB (69.44%).

Conclusions: This study establishes that ICA is safe and efficient in the first intention for the treatment of SIP of the mandibular molar.

Keywords: dental anaesthesia; dental emergency; local anaesthesia; mandibular molars; pain management; pulpotomy; symptomatic irreversible pulpitis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anesthesia, Dental* / methods
  • Anesthetics, Local
  • Double-Blind Method
  • Humans
  • Lidocaine
  • Mandibular Nerve
  • Nerve Block* / methods
  • Prospective Studies
  • Pulpitis* / surgery

Substances

  • Anesthetics, Local
  • Lidocaine

Associated data

  • ClinicalTrials.gov/NCT03802305