Clinical Evaluation of Buccal Infiltration with Articaine for Endodontic Anesthesia in Mandibular Molars with Irreversible Pulpitis

Background and Objectives: This study investigates the efficacy of 4% articaine buccal infiltration in patients with mandibular molar irreversible pulpitis. The goal is to understand the anatomical factors contributing to articaine’s success in mandibular infiltrations. Materials and Methods: A rand...

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Main Authors: Maria Rachel Monteiro, Carlos Fernando Mourão, Maria Cristina Volpato, Francisco Carlos Groppo, Francisco Haiter-Neto, Roberto Sacco, José Flávio Affonso de Almeida
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Oral
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Online Access:https://www.mdpi.com/2673-6373/4/4/41
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author Maria Rachel Monteiro
Carlos Fernando Mourão
Maria Cristina Volpato
Francisco Carlos Groppo
Francisco Haiter-Neto
Roberto Sacco
José Flávio Affonso de Almeida
author_facet Maria Rachel Monteiro
Carlos Fernando Mourão
Maria Cristina Volpato
Francisco Carlos Groppo
Francisco Haiter-Neto
Roberto Sacco
José Flávio Affonso de Almeida
author_sort Maria Rachel Monteiro
collection DOAJ
description Background and Objectives: This study investigates the efficacy of 4% articaine buccal infiltration in patients with mandibular molar irreversible pulpitis. The goal is to understand the anatomical factors contributing to articaine’s success in mandibular infiltrations. Materials and Methods: A randomized controlled trial was conducted with 50 patients diagnosed with symptomatic irreversible pulpitis in mandibular molars. Patients were divided into two groups: 4% articaine buccal infiltration (n = 30) and 2% lidocaine nerve block (n = 20). Pain was assessed using visual analog scales (VASs) before diagnosis, after thermal pulp sensitivity testing, and 5 and 10 min post-anesthetic application. Cone beam computed tomography (CBCT) was used to measure mandibular bone parameters. Results: The success rate for articaine buccal infiltration was 36.55%, with no significant difference between the efficacy in the first and second molars. CBCT measurements indicated no significant influence of buccal cortical bone thickness or distance from the mental foramen on anesthetic efficacy. However, articaine administration achieved anesthesia in some cases where lidocaine did not. Conclusions: Anatomical structures such as cortical bone thickness and distance from the mental foramen do not significantly influence the anesthetic efficacy of articaine in mandibular posterior infiltration for irreversible pulpitis treatment. These findings suggest that factors other than anatomical variations contribute to articaine’s superior performance in some clinical scenarios.
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spelling doaj-art-e068dc1878c44316ae9a50e7ab57aa032024-12-27T14:44:53ZengMDPI AGOral2673-63732024-11-014452553710.3390/oral4040041Clinical Evaluation of Buccal Infiltration with Articaine for Endodontic Anesthesia in Mandibular Molars with Irreversible PulpitisMaria Rachel Monteiro0Carlos Fernando Mourão1Maria Cristina Volpato2Francisco Carlos Groppo3Francisco Haiter-Neto4Roberto Sacco5José Flávio Affonso de Almeida6Department of Endodontics, School of Dental Medicine, Tufts University, Boston, MA 02111, USADepartment of Basic and Clinical Translational Sciences, School of Dental Medicine, Tufts University, Boston, MA 02111, USADepartment of Physiological Sciences, Pharmacology Division, Piracicaba Dental School, State University of Campinas, Piracicaba 13414-903, SP, BrazilDepartment of Physiological Sciences, Pharmacology Division, Piracicaba Dental School, State University of Campinas, Piracicaba 13414-903, SP, BrazilDepartment of Oral Diagnoses, Radiology Division, Piracicaba Dental School, State University of Campinas, Piracicaba 13414-903, SP, BrazilClinical Lecturer in Oral Surgery, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE1 9SP, UKDepartment of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas, Piracicaba 13414-903, SP, BrazilBackground and Objectives: This study investigates the efficacy of 4% articaine buccal infiltration in patients with mandibular molar irreversible pulpitis. The goal is to understand the anatomical factors contributing to articaine’s success in mandibular infiltrations. Materials and Methods: A randomized controlled trial was conducted with 50 patients diagnosed with symptomatic irreversible pulpitis in mandibular molars. Patients were divided into two groups: 4% articaine buccal infiltration (n = 30) and 2% lidocaine nerve block (n = 20). Pain was assessed using visual analog scales (VASs) before diagnosis, after thermal pulp sensitivity testing, and 5 and 10 min post-anesthetic application. Cone beam computed tomography (CBCT) was used to measure mandibular bone parameters. Results: The success rate for articaine buccal infiltration was 36.55%, with no significant difference between the efficacy in the first and second molars. CBCT measurements indicated no significant influence of buccal cortical bone thickness or distance from the mental foramen on anesthetic efficacy. However, articaine administration achieved anesthesia in some cases where lidocaine did not. Conclusions: Anatomical structures such as cortical bone thickness and distance from the mental foramen do not significantly influence the anesthetic efficacy of articaine in mandibular posterior infiltration for irreversible pulpitis treatment. These findings suggest that factors other than anatomical variations contribute to articaine’s superior performance in some clinical scenarios.https://www.mdpi.com/2673-6373/4/4/41articainebuccal infiltrationmandibular molarirreversible pulpitiscone beam computed tomography (CBCT)anesthetic efficacy
spellingShingle Maria Rachel Monteiro
Carlos Fernando Mourão
Maria Cristina Volpato
Francisco Carlos Groppo
Francisco Haiter-Neto
Roberto Sacco
José Flávio Affonso de Almeida
Clinical Evaluation of Buccal Infiltration with Articaine for Endodontic Anesthesia in Mandibular Molars with Irreversible Pulpitis
Oral
articaine
buccal infiltration
mandibular molar
irreversible pulpitis
cone beam computed tomography (CBCT)
anesthetic efficacy
title Clinical Evaluation of Buccal Infiltration with Articaine for Endodontic Anesthesia in Mandibular Molars with Irreversible Pulpitis
title_full Clinical Evaluation of Buccal Infiltration with Articaine for Endodontic Anesthesia in Mandibular Molars with Irreversible Pulpitis
title_fullStr Clinical Evaluation of Buccal Infiltration with Articaine for Endodontic Anesthesia in Mandibular Molars with Irreversible Pulpitis
title_full_unstemmed Clinical Evaluation of Buccal Infiltration with Articaine for Endodontic Anesthesia in Mandibular Molars with Irreversible Pulpitis
title_short Clinical Evaluation of Buccal Infiltration with Articaine for Endodontic Anesthesia in Mandibular Molars with Irreversible Pulpitis
title_sort clinical evaluation of buccal infiltration with articaine for endodontic anesthesia in mandibular molars with irreversible pulpitis
topic articaine
buccal infiltration
mandibular molar
irreversible pulpitis
cone beam computed tomography (CBCT)
anesthetic efficacy
url https://www.mdpi.com/2673-6373/4/4/41
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