Comparative evaluation of the effect of two pulpal medicaments on pain and bleeding status of mandibular molars with irreversible pulpitis post-failure of inferior alveolar nerve block: a double-blind, randomized, clinical trial

Complete relief of pain due to irreversible pulpitis is challenging to obtain with analgesic medications. The high incidence of an inferior alveolar nerve block (IANB) failure makes it difficult for practitioners to perform endodontic treatment without implementing other anesthetic techniques, espec...

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Bibliographic Details
Published in:PeerJ (San Francisco, CA) CA), 2022-05, Vol.10, p.e13397-e13397, Article e13397
Main Authors: Singh, Naomi Ranjan, Mishra, Lora, Pawar, Ajinkya M, Kurniawati, Nike, Wahjuningrum, Dian Agustin
Format: Article
Language:English
Subjects:
Amputation
Analgesics
Anesthesia
Anesthesiology and Pain Management
Anesthetics
Anesthetics, Local
Bleeding
Care and treatment
Clinical Trials
Cold
Dental pulp
Dentistry
Double-blind studies
Drugs and Devices
Endodontics
Failure
Humans
Hyperalgesia
Inferior alveolar nerve block
Irreversible pulpitis
Laboratory animals
Mandible
Mandibular Nerve
Molars
Nerve Block - methods
Pain
Pain - drug therapy
Pain perception
Paraformaldehyde
Patients
Pulpitis - therapy
Teeth
Visual analogue scale
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Summary:Complete relief of pain due to irreversible pulpitis is challenging to obtain with analgesic medications. The high incidence of an inferior alveolar nerve block (IANB) failure makes it difficult for practitioners to perform endodontic treatment without implementing other anesthetic techniques, especially mandibular molars. The aim of this study was to compare efficacies of two different quantities of paraformaldehyde based pulpal medicaments to relieve the pain and control hyperemic pulp post-failure of IANB and supplementary technique in patients experiencing this symptomatic irreversible pulpitis in the permanent mandibular tooth. Eighty-two participants with severe pain pre-operatively (Heft Parker Visual Analogue Scale, VAS > 114 mm) were enrolled, and pain responses were recorded at different time intervals using the Heft Parker visual analogue scale. To the patients experiencing pain even after the administration of the standard IANB and supplemental intraligamentary injection, one of the two paraformaldehyde based pulpal medicaments was placed in the pulp chamber and sealed. Participants were recalled after 24-48 h (second visit) to assess pain and bleeding reduction. Results showed a significant decrease in pain severity and bleeding score post medicament placement (  
ISSN:2167-8359
2167-8359
DOI:10.7717/peerj.13397