A parallel-arm randomized clinical trial evaluating the efficacy, injection pain, onset time, and duration of action of conventional 4 perctent articaine versus buffered 4 percent articaine versus buffered 4 percent articaine with palatal infiltration in patients with symptomatic irreversible pulpitis of maxillary first molars

A randomized parallel group clinical trial will be conducted to evaluate the anesthetic efficacy of conventional 4 percent articaine, buffered 4 percent articaine, and buffered 4 percent articaine with palatal infiltration in patients with symptomatic irreversible pulpitis in maxillary first molars. Achieving adequate anesthesia in such cases is often challenging due to inflammatory changes in pulpal tissues.

A total of 68 patients aged between 18 and 65 years will be randomly allocated into four groups. The interventions include conventional articaine, buffered articaine, double dose buffered articaine, and buffered articaine with additional palatal infiltration. Pain during injection, onset time, duration of anesthesia, and anesthetic success will be assessed using Heft Parker Visual Analog Scale and clinical evaluation.The study aims to determine whether buffering of articaine and use of supplemental palatal infiltration can improve anesthetic outcomes and patient comfort during endodontic procedures. The results of this study may help in optimizing anesthesia techniques for management of irreversible pulpitis in maxillary molars.