Thesis (M.Sc.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Endodontics

This prospective, randomized, double-blind clinical trial aimed to compare the efficacy of 2% mepivacaine with 1:100,000 epinephrine to 4% articaine with 1:100,000 epinephrine for inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis in mandibular molars.Methodology Sixty six patients diagnosed with symptomatic irreversible pulpitis in mandibular molar teeth randomly received 3.6 mL of 2% mepivacaine (2 carpules) or 3.4 mL of 4% articaine (2 carpules) both with 1:100,000 epinephrine, using a conventional IANB technique. Endodontic access cavities were prepared 15 minutes after solution deposition, and all patients were required to have profound lip numbness. Success was defined as no or mild pain (numerical rating scale recording) upon endodontic access cavity preparation or initial canal instrumentation and the patients who needed supplemental anesthesia were counted and there was no statistically significant difference in the need for supplemental anesthesia in both groups.. Finally, the collected data were subjected to independent t-test, Chi-square and Fisher{u2019}s exact test by using SPSS software at a significant level of 0.05. Results The success rates for IANB using mepivacaine and articaine were 27.3% and 33.3%, respectively, where both groups showed no statistically significant difference(P<0.05).Conclusion For mandibular molars with symptomatic irreversible pulpitisThe anesthetic efficacy was similar for both mepivacaine and articaine, and neither solution resulted in complete pulpal anesthesia and the need for supplemental anesthesia was similar in the group of mepivacaine and the group of articaine, and both groups showed high rate of need for supplemental anesthesia to control pain during treatment

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