Comparing intraosseous computerized anaesthesia with inferior alveolar nerve block in the treatment of symptomatic irreversible pulpitis: A randomized controlled trial

• Published in: International endodontic journal 2023-08, Vol.56 (8), p.922-931
• Main Authors: Gaudin, Alexis, Clouet, Roselyne, Boëffard, Camille, Laham, Amany, Martin, Hamida, Amador Del Valle, Gilles, Enkel, Bénédicte, Prud'homme, Tony
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesia, Dental; Anesthetics, Local; Blood pressure; dental anaesthesia; dental emergency; Double-Blind Method; Heart rate; Human health and pathology; Humans; Lidocaine; Life Sciences; local anaesthesia; Local anesthesia; Mandible; mandibular molars; Mandibular Nerve; Nerve Block; Oxygen saturation; pain management; Prospective Studies; Pulpitis; pulpotomy; Statistical analysis; symptomatic irreversible pulpitis
• ISSN: 0143-2885; 1365-2591
• DOI: 10.1111/iej.13935

Aim The aim of this study was to compare the cardiovascular effects [heart rate, oxygen saturation (SpO2), systolic and diastolic blood pressure] and the anaesthetic efficacy of intraosseous computerized anaesthesia (ICA) versus inferior alveolar nerve block (IANB) in Symptomatic irreversible pulpitis (SIP). Methodology The study protocol was registered with ClinicalTrials.gov (NCT03802305). In a randomized, prospective clinical trial, 72 mandibular molar teeth with SIP were randomly allocated to conventional IANB injection (n = 36) or ICA injection (n = 36), both with 1.8 mL of 4% articaine with 1:100 000 epinephrine. The primary objective was to assess the cardiovascular parameters (heart rate, oxygen saturation, blood pressure) before, during and after the anaesthesia. The secondary objectives were to compare ICA with IANB for success and postoperative outcomes for up to 3 days. Results The maximum increase in heart rate in the ICA group was greater than in the IANB. Other cardiovascular parameters did not show differences throughout the clinical procedure. There were no statistically significant differences (p > .05) between groups for sex, age, or anxiety. The total success rate of ICA (91.43%) was significantly higher (p = .0034) than that of IANB (69.44%). Conclusions This study establishes that ICA is safe and efficient in the first intention for the treatment of SIP of the mandibular molar.