Anesthetic Efficacy of 2% Mepivacaine Versus 4% Articaine

Phase 2

Brief Summary: The aim of this prospective randomized clinical trial was compare between 2% Mepivacaine and 4% Articaine for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis in mandibular molars as regards to their anesthetic efficiency; during access cavity preparation and instrumentation.

Detailed Description: Sixty-six patients diagnosed clinically and radiographically with symptomatic irreversible pulpitis in mandibular posterior teeth will received single-visit root canal treatment using ProTaper Universal rotary system for canal preparation, then they will be randomly divided into two groups (n=33) according to the anesthetic solution used, either Group M (3.6 ml Mepivacaine hydrochloride 2% with 1:100000 epinephrine) or Group A (3.4 ml Articaine hydrochloride 4% with 1:100000 epinephrine). The pain will be assessed using numerical rating scale (NRS) during access cavity preparation and instrumentation, then the need for supplemental anesthesia will be also recorded.

Recruitment & Eligibility

Inclusion Criteria

Patients in good health (American Society of Anesthesiologists Class II or higher)
Patients having symptomatic irreversible pulpitis in one of their mandibular molars.
Age range is between 20 and 50 years.
Patients who can understand Visual Analogue Scales VAS.
Patients able to sign informed consent

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
articaine hydrochloride	articane hydrochloride	4 % Articaine hydrochloride with 1:100,000 epinephrine anaesthetic solution. Each patient received two inferior alveolar nerve block injections of the tested anesthetic solution by using a side loading aspirating syringe and 27-gauge long needle
mepivacaine hydrochloride	mepivicane hydrochloride	2% Mepivacaine hydrochloride with 1:100,000 epinephrine anaesthetic solution. Each patient received two inferior alveolar nerve block injections of the tested anesthetic solution by using a side loading aspirating syringe and 27-gauge long needle
mepivacaine hydrochloride	articane hydrochloride	2% Mepivacaine hydrochloride with 1:100,000 epinephrine anaesthetic solution. Each patient received two inferior alveolar nerve block injections of the tested anesthetic solution by using a side loading aspirating syringe and 27-gauge long needle
articaine hydrochloride	mepivicane hydrochloride	4 % Articaine hydrochloride with 1:100,000 epinephrine anaesthetic solution. Each patient received two inferior alveolar nerve block injections of the tested anesthetic solution by using a side loading aspirating syringe and 27-gauge long needle

Primary Outcome Measures

Name	Time	Method
Pain intensity: Numerical rating scale (NRS)	Fifteen minutes after injection of the anaesthetic solution	Pain intensity during access cavity preparation using numerical rating scale (NRS). The scale was numerical to facilitate its use by the participants. The Numerical rating scale is an 10-point scale anchored by two extremes "No pain" and "pain as bad as it could be". Pain was categorized into four categorical scores: (1) none \[score 0\], (2) mild \[score from 1-3\], (3) moderate \[score from 4-6\], (4) severe \[score from 7-10\].

Secondary Outcome Measures

Name	Time	Method
Pain intensity: Numerical rating scale (NRS)	Twenty-five minutes after injection of the anaesthetic solution	Pain intensity during root canal negotiation and instrumentation using Numerical rating scale is an 10-point scale anchored by two extremes "No pain" and "pain as bad as it could be". Pain was categorized into four categorical scores: (1) none \[score 0\], (2) mild \[score from 1-3\], (3) moderate \[score from 4-6\], (4) severe \[score from 7-10\].
The number of patients who need suplemental anesthesia	Fifteen minutes after injection of the anaesthetic solution	counting the number of the number of patients who need suplemental anesthesia