ArticleJournal of conservative dentistry and endodontics2026
Comparative evaluation of supplemental buccal infiltration adjuncts for enhancing inferior alveolar nerve block in symptomatic irreversible pulpitis: A randomized double-blind clinical study.
Article in Journal of conservative dentistry and endodontics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Achieving profound pulpal anesthesia in mandibular molars with symptomatic irreversible pulpitis remains challenging, with inferior alveolar nerve block (IANB) failure rates up to 80%. This study evaluated the effect of supplemental buccal infiltration using tramadol, dexamethasone, ketorolac, and temperature-modified lidocaine on the efficacy of IANB. Materials and Methods: In this randomized, double-blind clinical trial, 120 patients were allocated to six groups ( Results: Anesthetic success rates were 90% (95% confidence interval [CI], 68%-99%) for tramadol, and 85% (95% CI, 62%-97%) for cold lidocaine, significantly higher than control (40%, Conclusion: Supplemental buccal infiltration with tramadol or cold lidocaine significantly enhances IANB success in mandibular molars with irreversible pulpitis, offering a simple, safe, and cost-effective approach to improve pulpal anesthesia.
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