In vivo comparison of postoperative pain using two different techniques for local anesthesia in single-sitting root canal treatment

Aim: This in vivo split-mouth randomized control trial was carried out to study and compare the incidence of postoperative pain associated with single-sitting endodontic treatment using inferior alveolar nerve block and intraligamentary injection as primary anesthetic technique. Methods: A total of 30 patients with bilateral symptomatic irreversible pulpitis in mandibular molars were selected to be included in the study. In each subject, molar in one quadrant was randomly assigned to Group 1 (intraligamentary injection), and the molar in the opposite quadrant was assigned to Group 2 (inferior alveolar nerve block). The root canal procedures for the patients were carried out in single sittings under rubber dam using hand ProtaperTM system, 2.5% sodium hypochlorite as irrigant alternating with normal saline and obturation by the lateral condensation technique. A questionnaire employing Visual Analog Scale (VAS) for pain assessment was given to the patient and instructions on how to fill the form were given. VAS scores for every tooth treated in every patient were recorded before beginning treatment and after completion of treatment for each tooth. The patients were recalled after 2 days, and the scores were analyzed. The results were tabulated and statistically analyzed for incidence and degree of pain. Results: Group 1 and Group 2 showed a steady reduction in postoperative pain from 4 h to 48 h as seen in the mean VAS scores. Comparison between the two groups at each time interval showed a difference which was statistically insignificant (P > 0.05). Conclusion: There is no difference in the incidence of postoperative pain when either inferior alveolar nerve block or intraligamentary injection is employed as the primary technique for achieving anesthesia during single-sitting root canal treatment.