Although supplementary injection techniques are used, complete pulpal anesthetic success is challenging. These failures may be overcome by administering supplementary techniques ( Lee & Yang, 2019). Additionally, there is a relatively high inaccuracy of IANB block due to needle deflection ( Kennedy et al., 2003 Khalil, 2014). The other reason could be that local anaesthetic action reduces the presence of a tetrodotoxin-resistant class of sodium channels ( Roy & Narahashi, 1992). Moreover, nociceptors exhibit decreased excitability threshold due to chemokines and cytokines released in inflammation ( Modaresi, Dianat & Soluti, 2008). The reasons could be that patients with symptomatic irreversible pulpitis or acute apical periodontitis are often more apprehensive, which lowers the pain threshold. Unfortunately, IANB is proven to have substantial failure rates ranging between 43%–83% ( AlHindi, Rashed & AlOtaibi, 2016 Fowler et al., 2016 Madan, Madan & Madan, 2002 Nagendrababu et al., 2019 Sivaramakrishnan, Alsobaiei & Sridharan, 2019). Posterior teeth are routinely anesthetized in the mandibular arch using the inferior alveolar nerve block (IANB) technique. Paraformaldehyde based pulpal medicament can be used as an alternative to manage pain in patients having severe irreversible pulpitis and hyperalgesia.Īdequate local anesthesia (LA) is crucial in dental treatment, especially in managing irreversible pulpitis.
Hence judicious use within a recommended period, pulpal medicaments can be considered safe. Results showed a significant decrease in pain severity and bleeding score post medicament placement ( p < .05). Participants were recalled after 24–48 h (second visit) to assess pain and bleeding reduction. 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. MethodĮighty-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.
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. 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. PeerJ 10: e13397 Ĭomplete relief of pain due to irreversible pulpitis is challenging to obtain with analgesic medications. 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. Cite this article Singh NR, Mishra L, Pawar AM, Kurniawati N, Wahjuningrum DA. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited. Licence This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. Customer from Salzgitter placed a new order for Ospamox (Amoxicillin) powder for oral suspension 250mg / 5ml 6.3 Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlingga, Surabaya City, East Java, Indonesia DOI 10.7717/peerj.13397 Published Accepted Received Academic Editor Shivam Mehta Subject Areas Anesthesiology and Pain Management, Clinical Trials, Dentistry, Drugs and Devices Keywords Hyperalgesia, Inferior alveolar nerve block, Irreversible pulpitis, Paraformaldehyde, Visual analogue scale Copyright © 2022 Singh et al.
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