Irreversible pulpitis: What is the most effective local anaesthetic for inferior alveolar nerve block?

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This review of the most effective anaesthetic solutions for inferior alveolar nerve blocks for mandibular teeth with irreversible pulpitis included 11 RCTs. The findings suggest that mepivacaine with epinephrine performed better than lidocaine with epinephrine but the number of trials is limited and the quality of evidence was very low to moderate.

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Inferior alveolar nerve block: mepivacaine-lidocaine no better than lidocaine alone suggests trial

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This well conducted and reported trial found that there was no difference between 3% mepivacaine & 2% lidocaine with 1:100,000 epinephrine and 2 cartridges of 2% lidocaine with 1:100,000 epinephrine in terms of injection pain, onset time, and pulpal anesthetic success for the IAN block.

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