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Retromolar canal infiltration as a supplement to the inferior alveolar nerve block injection: an uncontrolled clinical trial

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Abstract

Objectives

This study aimed to determine the success rate of retromolar canal (RMC) infiltration following the failure of inferior alveolar nerve block (IANB) injections for the anesthesia of mandibular first molars with acute irreversible pulpitis.

Materials and methods

An IANB injection was administered for 50 patients with acute irreversible pulpitis. Lip numbness was set as the sign of anesthesia and further evaluated and confirmed with pulp sensibility tests after 10–15 min. Access cavity preparation was commenced unless the patient felt any pain; in this case, an RMC infiltration injection was given. The success rate was determined through the patients’ recording of the presence, absence, or reduction of pain severity during access cavity preparation using the Heft-Parker visual analog scale.

Results

Seven patients (14%) did not experience any pain by pulp sensibility tests and during access cavity preparation after IANB injection. Twenty-five (58.1%) of the remaining 43 patients who had the RMC infiltration injection had reduced pain, and four patients (9.3%) experienced no pain after the RMC infiltration. Fourteen patients (32.5%) experienced no change in pain. Chi-squared test results revealed that the percentage of patients with reduced pain was higher than that of other patients (P < 0.001).

Conclusions

RMC infiltration, along with IANB, significantly reduced the pain felt by patients and increased the success of the anesthetic technique for root canal treatment of mandibular first molars with acute irreversible pulpitis.

Clinical relevance

The administration of RMC infiltration can enhance the success of the IANB technique for anesthetizing mandibular first molars exhibiting acute irreversible pulpitis.

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Acknowledgements

MAS is a recipient of New Jersey Health Foundation Award. The views expressed in this paper are those of the authors and do not necessarily reflect the views or policies of the affiliated organizations. The authors hereby announced that they have active cooperation in this scientific study and preparation of present manuscript. The authors confirm that they have no financial involvement with any commercial company or organization with direct financial interest regarding the materials used in this study.

Funding

The work was self-funded.

Author information

Authors and Affiliations

  1. Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Ghasrodasht st, Shiraz, Iran

    Kasra Karamifar

  2. Sector of Angiogenesis Regenerative Medicine, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA

    Kasra Karamifar

  3. Department of Endodontics, Dental School, Shiraz Azad University, Shiraz, Iran

    Dorna Shirali

  4. Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA

    Mohammad Ali Saghiri

  5. Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA

    Mohammad Ali Saghiri

  6. Clinical Dentistry, UWA Dental School, University of Western Australia, Perth, Australia

    Paul V. Abbott

Authors
  1. Kasra Karamifar
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  2. Dorna Shirali
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  3. Mohammad Ali Saghiri
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  4. Paul V. Abbott
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Contributions

Designed the experiment: KK, DS, MAS, PVA. Conducted the experiment: KK and DS. Analyzed/interpreted data: KK, DS, MAS, PVA. Wrote the article: KK, DS, MAS, PVA. Proofed/revised article: KK, DS, MAS, PVA.

Corresponding author

Correspondence to Kasra Karamifar.

Ethics declarations

Ethics approval and consent to participate

All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no conflict of interest.

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Highlights

• Retromolar canal infiltration, along with inferior alveolar nerve block, can reduce the severity of pain felt by patients with mandibular first molars with acute irreversible pulpitis.

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Karamifar, K., Shirali, D., Saghiri, M.A. et al. Retromolar canal infiltration as a supplement to the inferior alveolar nerve block injection: an uncontrolled clinical trial. Clin Oral Invest 25, 5473–5478 (2021). https://doi.org/10.1007/s00784-021-03855-2

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  • DOI: https://doi.org/10.1007/s00784-021-03855-2

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