Anaesthetic efficacy of supplemental lingual infiltration of mandibular molars after inferior alveolar nerve block plus buccal infiltration in patients with irreversible pulpitis.

AIM: To investigate the effect of supplemental lingual infiltration (LI) of mandibular molars following an inferior alveolar nerve block (IANB) plus buccal infiltration (BI) in patients with irreversible pulpitis. METHODOLOGY: Eighty adult patients diagnosed with irreversible pulpitis participated in this prospective study. All patients received standard IANB via injection of 4 mL of 2% lidocaine with 1 : 100,000 epinephrine. Ten minutes after the IANB, patients with numbness of the lower lip were randomly divided into two groups. In the BI group, 40 patients received supplemental BI of 0.9 mL of 4% articaine with 1 : 100,000 epinephrine. In the buccal plus lingual infiltration (BLI) group, 40 patients received supplemental BI of 0.9 mL of 4% articaine with 1 : 100,000 epinephrine and, subsequently, LIs with the same anaesthetic solution and dose. Endodontic access cavity preparation began 15 min after the IANB. Pain during treatment was recorded using a Heft-Parker visual analogue scale. Success was defined when pain was 'none' or 'mild' on endodontic access and initial instrumentation. The pain was estimated and statistically analysed by the chi-squared test (alpha = 0.05). RESULTS: The success rates for the BI and BLI groups were 70% and 62.5%, respectively. No statistical difference was found between the two groups (P = 0.478). CONCLUSIONS: Supplemental LIs are not recommended for administration in mandibular molars with irreversible pulpitis, because they do not improve the anaesthetic success after IANB plus BI.