Comparison of Anesthetic Efficacy OF 2% Lidocaine Inferior Alveolar Nerve (IANB) Block Versus Primary Buccal Infilteration With 4% Articaine in Symptomatic Irreversible Pulpitis(SIP) IN Mandibular First Molars

NCT07409896 | Not Yet Recruiting

• 1 other identifier: SS-ENDO-IANBART-2025
• Study Type: interventional
• Target: 330
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to compare the anesthetic efficacy of 2% lignocaine administered through an inferior alveolar nerve block (IANB) in one group of participants with 4% articaine delivered via primary buccal infiltration in other group in patients with symptomatic irreversible pulpitis in mandibular first molars.

Conditions

Anesthetic Efficacy

Outcome Measures

Primary Outcomes (1)

• Anesthetic efficacy

  Description: Patients will be assigned to one of the two groups . Group 1: 2%Lignocaine 1;80,000 epinephrine 1.8 ml IANB Group 2: 4%Articaine 1:100,000 epinephrine 1.8 ml Primary buccal infilteration Efficacy will be considered if there are 2 consecutive non-responsive readings during 60 mins duration , usually measured on EPT 15 mins after administration of anesthesia . Any pain felt during the procedure will be measured according to Heft-Parker VAS and moderate-severe pain reported (VAS ≥ 55) will be regarded unsuccessful . Time Frame: 1 hour after administration of local anesthetic agent .

  1 hour after administration of anesthetic agent

Secondary Outcomes (1)

• Duration of anesthesia

  1 hour 30 mins

Study Arms (2)

ARM 1 : 2%Lignocaine 1:80,000 epinephrine

ACTIVE COMPARATOR

: 2% Lignocaine Inferior Alveolar Nerve Block (IANB) Participants in this group will receive an inferior alveolar nerve block using 2% Lignocaine with 1:80,000 epinephrine.

Other: INTERVENTION 1: 2% Lignocaine 1:80,000 epinephrine

ARM 2 : 4% Articaine with 1:100,000 epinephrine

ACTIVE COMPARATOR

Participants in this group will receive 4% Articaine with 1:100,000 epinephrine at the site of the mandibular first molar.

Other: INTERVENTION 2 : 4%Articaine 1:100,000 epinephrine

Interventions

INTERVENTION 2 : 4%Articaine 1:100,000 epinephrine OTHER

Participants in this group will receive a buccal infiltration of 4% Articaine with 1:100,000 epinephrine at the site of the mandibular first molar. The injection will follow standard buccal infiltration technique. Anesthetic efficacy will be evaluated during endodontic treatment using the same pain assessment method as Arm 1.

ARM 2 : 4% Articaine with 1:100,000 epinephrine

INTERVENTION 1: 2% Lignocaine 1:80,000 epinephrine OTHER

2% Lignocaine Inferior Alveolar Nerve Block (IANB) : Participants in this group will receive an inferior alveolar nerve block using 2% Lignocaine with 1:80,000 epinephrine. The injection will be administered following standard IANB technique for mandibular first molars. The anesthetic efficacy will be assessed with 2 consecutive non responsive readings on EPT objectivelt and via Heft-Parker VAS not more than ≥55 .

ARM 1 : 2%Lignocaine 1:80,000 epinephrine

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Systemically healthy patients classified as ASA I, aged 18-55 years.
• Permanent mandibular first molar tooth requiring endodontic therapy.
• Diagnosed with symptomatic irreversible pulpitis without swelling or sinus.
• Normal periapical radiographic appearance (no evidence of periapical pathology).
• Moderate pain as assessed by the Heft-Parker VAS (\>54 mm and \<114 mm).
• Lingering pain or prolonged response to cold testing (lasting more than 10 seconds).
• Positive response to electric pulp testing.
• Outcome assessed must be pulpal anesthesia

You may not qualify if:

• Pregnant or lactating mothers.
• Teeth with reversible pulpitis, previously treated, or with calcified canals.
• Teeth with severe periodontal disease or periapical radiolucency.
• Patients who have taken analgesics or anti-inflammatory drugs within 6 hours before the treatment visit.
• Patients on medications that could potentially interact with the anesthetic solution (e.g., antihypertensives, anticoagulants).
• History of allergy to 4% articaine, lidocaine, or epinephrine.
• Systemic diseases, immunocompromised states, or significant anxiety/mental health disorders.
• History of vasovagal syncope on local anesthetic administration

Sponsors & Collaborators

• Armed Forces Institute of Dentistry, Pakistan: lead

Study Sites (1)

Armed Forces Institute of Dentistry AFID CMH Rawalpindi

Rawalpindi, Punjab Province, 46000, Pakistan

Location

Related Links

• Comparison Of Anaesthetic Efficacy Of Articaine And Lidocaine In Nonsurgical Endodontic Treatment Of Permanent Mandibular Molars With Symptomatic Irreversible Pulpitis. A Randomized Clinical Trial

MeSH Terms

Interventions

Lidocaine; Epinephrine

Intervention Hierarchy (Ancestors)

Acetanilides; Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines; Ethanolamines; Amino Alcohols; Alcohols; Biogenic Monoamines; Biogenic Amines; Catecholamines; Catechols; Phenols; Benzene Derivatives; Hydrocarbons, Aromatic; Hydrocarbons, Cyclic; Hydrocarbons

Central Study Contacts

Dr. Sadia Shehzadi Dr. Sadia Shehzadi, BDS,FCPS(PG3)

CONTACT

03342073051; sadiashehzadi321@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants will be blinded to the type of local anesthetic technique administered. They will not be informed whether they received an IANB with 2% Lignocaine or Buccal Infilteration with 4% Articaine. The operator and investigator can not be blindeddue to the nature of the procedure.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr. Sadia Shehzadi

Study Record Dates

• First Submitted: December 7, 2025
• First Posted: February 13, 2026
• Study Start: February 1, 2026
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): February 1, 2027
• Last Updated: February 13, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)