Trial reportEuropean endodontic journal2023
Effect of Cooling of Lidocaine with Epinephrine on the Anesthetic Success of Supplementary Intraligamentary Injection after a Failed Primary Inferior Alveolar Nerve Block: A Randomized Controlled Trial.
Trial report in European endodontic journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.
- Efficacy of Combined Versus Supplementary Injection Techniques With Inferior Alveolar Nerve Block for Mandibular Molars With Symptomatic Irreversible Pulpitis: A Systematic Review and Network Meta-Analysis.International endodontic journal · 2025Pooled it
- Effect of intrapulpal cryoanesthesia on intraoperative pain during root canal treatment in mandibular molars: a double blinded randomized control trial.Scientific reports · 2025Trial
- Pain Management in Mandibular Molars With Symptomatic Irreversible Pulpitis: Mechanisms, Clinical Efficacy and Current Evidence: A Narrative Review.Pain research & management · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe purpose of this prospective, randomized clinical trial was to evaluate the effect of cooling a 2% lidocaine solution with 1: 200,000 epinephrine, administered as a supplementary intraligamentary injection to overcome a failed primary inferior alveolar nerve block (IANB).
methodsThe study was preceded by a pilot study to evaluate the anesthetic efficacy of plain lidocaine solutions given as intraligamentary injections. In the subsequent randomized clinical trial, one hundred and thirty-eight patients received IANB with 2% lidocaine with 1: 80,000 epinephrine for endodontic man- agement of a mandibular molar with symptomatic irreversible pulpitis. Eighty-eight patients reported pain greater than 54 mm on a visual analog scale (Heft-Parker VAS) were categorized as unsuccessful anesthesia. These patients received either of the following intraligamentary injections: 2% lidocaine with 1: 200,000 epinephrine at room temperature; or 2% lidocaine with 1: 200,000 epinephrine at 4°C. Anes- thetic success was again evaluated after re-initiation of the endodontic treatment. The heart rates of the patients were measured using a finger pulse oximeter. The categorical success rates were statistically analyzed with the Pearson chi-square test at 5% significance levels. The heart rate measurements were analyzed using a t-test.
resultsThe intraligamentary injections with anesthetic solutions at room temperature presented a suc- cess rate of 59.1%, while the injections with a solution at 4°C gave a success rate of 52.27%. There were no significant differences between the success rates of the groups (χ2=0.41, p=0.52). Regarding the heart rates, there were no differences between the two solutions at baseline (T=1.2, p=0.2) or after injections (T=0.64, p=0.52).
conclusionReducing the temperature of 2% lidocaine with 1: 200,000 epinephrine to 4°C does not affect the anesthetic efficacy of supplemental intraligamentary injections, given after a failed primary IANB. (EEJ-2023-03-044).
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