Efficacy of combining a buccal infiltration with an inferior alveolar nerve block for mandibular molars with irreversible pulpitis.

Objective: The aim of this study was to assess the efficacy of inferior alveolar nerve (IAN) block combined with buccal infiltration for mandibular molars with irreversible pulpitis.

Methodology: Eighty-four patients were randomly assigned to 3 groups of 28 patients each. Lidocaine 2% with 1:80,000 epinephrine was used for all injections. Group I patients received an IAN block with 1.8 mL of anesthetic. Group II patients received an IAN block using 3.6 mL. Group III patients received 1.8 mL as an IAN block and 1.8 mL as a buccal infiltration. A visual analogue scale was used to rate pain before anesthesia and discomfort experienced before and during access cavity preparation. Data were analyzed by chi-square, ANOVA, Kruskal-Wallis, and Mann-Whitney tests.

Results: The success rates for groups I to III were 14.8%, 39.3%, and 65.4%, respectively. Group III had significantly better anesthesia compared with group I (P < .05).

Conclusion: Combining an IAN block and a buccal infiltration injection provided more effective anesthesia in mandibular molars with irreversible pulpitis. However, some cases may still require further anesthesia to prevent pain during endodontic treatment.