Anesthetic Effectiveness of Mental/Incisive Nerve Block versus Inferior Alveolar Nerve Block in Mandibular First and Second Premolars with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial.

Abstract

Introduction: This study aimed to compare the effectiveness of mental/incisive nerve block (MINB) and conventional inferior alveolar nerve block (IANB) anesthesia during endodontic treatment of mandibular first and second premolars with symptomatic irreversible pulpitis.

Methods: In this randomized, double-blind, clinical trial, 120 patients undergoing endodontic treatment of mandibular premolars were randomly assigned to IANB (n = 60) or MINB (n = 60) using 1.8 mL 4% articaine with 1:100,000 epinephrine hydrochloride. Pain levels were evaluated preoperatively and during cold tests, cavity preparation, and pulp extirpation using the Numerical Rating Scale. Statistical analyses included the independent t test, chi-square test, and Mann-Whitney U test (α = 0.05).

Results: Both groups showed a success rate of 70% for anesthesia (P = 1.000). While IANB demonstrated similar efficacy between first (71.4%) and second (68.8%) premolars (P > .05), MINB was significantly more effective for first premolars (76.9%) than second premolars (64.7%) (P < .05).

Conclusions: MINB and IANB provide comparable pain control for mandibular premolars during endodontic procedures. However, MINB was observed to be less effective for second premolars compared to first premolars. The study suggests that, despite the comparable success rates of both anesthesia techniques, supplemental anesthesia may still be required to achieve adequate pain management for mandibular premolars with symptomatic irreversible pulpitis.