Anaesthetic efficacy of supplementary buccal infiltration vs intraligamentary injection with articaine in irreversible pulpitis cases.

Dr. Jaiti Gupte; Dr. Ushaina Fanibunda; Dr. Vibha Hegde; Dr. Sharad Kokate

Volume : VII, Issue : XI, November - 2018

Anaesthetic efficacy of supplementary buccal infiltration vs intraligamentary injection with articaine in irreversible pulpitis cases.

Dr. Jaiti Gupte, Dr. Ushaina Fanibunda, Dr. Vibha Hegde, Dr. Sharad Kokate

Abstract :

Background

Local anaesthetics form the back bone of pain control in dentistry. However teeth with symptomatic irreversible pulpitis or �hot teeth� classically resist the action of standard anaesthetic regimens and often pose a clinical challenge. Supplementary injections & alternative solutions have been investigated. The purpose of this study is to determine the anaesthetic efficacy of supplementary buccal infiltration or intraligamentary injection of 4% articaine with 1:100,000 epinephrine when the conventional IANB of 2% lidocaine with 1:80,000 epinephrine failed in patients with irreversible pulpitis in mandibular posterior teeth.

Methodology: Patients with irreversible pulpitis in mandibular posterior teeth received an Inferior Alveolar Nerve Block (IANB) of 2% lidocaine. Subjects who showed IANB failure received either 4% articaine as a buccal infiltration (group 1) or 4% articaine as an intraligamentary injection (group 2). The subjects� self–reported pain response was recorded on Heft Parker Visual Analogue Scale during access cavity preparation & pulp extirpation.

Results: Both the techniques resulted in improved success rates compared to a plain IANB which had a success rate of 52 %. The supplementary buccal infiltration and intra–ligamentary injection had a success rate of 66% and 76% respectively, with no significant difference between them.

Conclusion: Supplementary injections with articaine using either intraligamentary or buccal infiltration techniques, result in an improved success rate and may be implemented as an initial supplementary injection prior to commencement of the root canal procedure. However, no technique provides 100% predictable anaesthesia and reinjection may be necessary.