Comparison of Anesthetic Effectiveness of Different Volumes of Articaine for Inferior Alveolar Nerve Block In Molar Teeth With Symptomatic Irreversible Pulpitis

Objective: To compare the efficacy of different volumes of articaine in achieving Inferior Alveolar Nerve Block (IANB) anesthesia, in patients diagnosed with symptomatic irreversible pulpitis. Study Design: Randomized controlled trial (NCT05840913). Place and Duration of Study: Armed Forces Institute of Dentistry (AFID), Combined Military Hospital (CMH), Rawalpindi, Pakistan, from Dec 2023 to Jan 2024. Methodology: A total of 78 patients with symptomatic irreversible pulpitis were enrolled in the clinical trial using a double-blind, randomized approach, to receive either 1.8 mL or 3.6 mL of articaine in an inferior alveolar nerve block. Pain levels were assessed using the Visual Analog Scale (VAS) before, during, and after the procedure. A successful anesthesia was defined by minimal or no pain; moderate to severe pain indicated anesthesia failure. Data was analyzed using chi-square and t-tests, with significance set at p-value ≤ 0.05. Results: Significant differences were observed between the two groups during stages of dentin preparation and pulp chamber opening, with a p-value < 0.001, where Group 2, receiving 3.6 mL of articaine, had a final success rate of 79.49%, significantly higher than the 30.77% observed in Group 1, which received 1.8 mL (p < 0.001). Although there was no significant difference in pain levels 15 minutes after anesthesia (p = 0.387) or during root canal instrumentation (p= 0.185), severe pain was notably higher during the pulp exposure stage in Group 1 (17.95%). Conclusion: The higher volume of articaine increased the IANB anesthesia effect in mandibular molars among patients with symptomatic irreversible pulpitis.