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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Articaine better than lidocaine for supplementary infiltration after mandibular block anaesthesia

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10 studies involving 746 adult patients were included in this review comparing articaine and lidocaine in patients with symptomatic irreversible pulpitis. Articaine was as effective as lidocaine and provided better supplementary infiltration after mandibular block but no other advantages.

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Supplementary injections to increase numbers of patients receiving pain-free dental treatment

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Unfortunately for patients  with irreversible pulpitis inferior alveolar nerve block (IANB) is not always successful in achieving satisfactory levels of anaesthesia. The aim of this study was to compare the efficacy of supplementary repeat inferior alveolar nerve block with 2% lidocaine and epinephrine, buccal infiltration with 4% articaine with epinephrine, intraligamentary injection, or intraosseous injection [read the full story…]