Evaluation of different type of anesthetic techniques on anesthetic success rates in mandibular premolars with symptomatic irreversible pulpitis

The inferior alveolar nerve block (IANB) is the most commonly used technique for achieving pulpal anesthesia for posterior mandibular endodontic procedures. In mandibular premolars, buccal infiltration provides adequate anesthesia. The purpose of this prospective randomized study is to compare IANB and buccal infiltration on anesthetic success rates. Adult volunteer subjects will be selected from dental OPD and included in this prospective, randomized study. The success is defined as the ability to undertake pulp access and canal instrumentation with no or mild pain (Heft-Parker VAS score<55mm). The subjects should be actively experiencing pain and in good health, and none will be taking any medication that would alter pain perception, as determined by oral questioning and written questionnaire. An informed written consent will be obtained from each subject. The patients will be randomly allocated to the treatment groups. Patients will receive standard inferior alveolar nerve block or buccal infiltrations. A conventional access opening will be initiated after isolation with a rubber dam. Patients will be instructed to raise their hand if any pain was felt during the procedure. In case of pain during the treatment, the procedure will be stopped, and patients asked to rate the pain on HP VAS. Success will be defined as no pain or weak/mild pain during endodontic access preparation and instrumentation .