A Comparison of Different Volumes of Articaine for Inferior Alveolar Nerve Block for Molar Teeth with Symptomatic Irreversible Pulpitis

Introduction: Achieving anesthesia in mandibular molar teeth with irreversible pulpitis is very difficult. The aim of this study was to compare the efficacy of 1.8 mL and 3.6 mL articaine for an inferior alveolar nerve block (IANB) when treating molars with symptomatic irreversible pulpitis. Methods: In a randomized, double-blind clinical trial, 82 first mandibular molar teeth with symptomatic irreversible pulpitis randomly received conventional IANB injection either with 1 (1.8 tit) or 2 cartridges (3.6 mL) of 4% articaine with 1:100,000 epinephrine. The patients recorded their pain before and during access cavity preparation as well as during root canal instrumentation using a Heft-Parker visual analog scale. No or mild pain was considered as successful anesthesia. Data were analyzed by t and chi-square tests. Results: Eighty patients were eligible to participate in this study, which showed that 3.6 mL articaine provided a significantly higher success rate (77.5%) of IANBs compared with 1.8 mL of the same anesthetic solution (27.5%) although neither group had 100% successful anesthesia (P < .001). Conclusions: Increasing the volume of articaine provided a significantly higher success rate of IANBs in mandibular first molar teeth with symptomatic irreversible pulpitis, but it did not result in 100% anesthetic success.