COMT, MAOA, and SLC6A4 Polymorphisms and Inferior Alveolar Nerve Block Success

NCT07697300 | Completed

• 1 other identifier: 25.09.2025/2025-66
• Study Type: interventional
• Target: 95
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study was to evaluate the association between COMT, MAOA, and SLC6A4 genetic polymorphisms and the success of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis in mandibular molars. Patients presenting with moderate to severe pain were enrolled. Before anesthesia, pain intensity was assessed using the Heft-Parker Visual Analog Scale (HP-VAS), and pulpal vitality was evaluated using cold and electric pulp tests. All participants received a standardized inferior alveolar nerve block with 4% articaine containing epinephrine. Fifteen minutes after injection, pulpal anesthesia was reassessed using cold and electric pulp tests. Patients who continued to respond to these tests were considered to have unsuccessful pulpal anesthesia and were excluded from the study. Patients with no response to either test were included in the study, and root canal treatment was initiated. Pain experienced during the procedure was assessed using the HP-VAS. Buccal swab samples were collected for genomic DNA isolation, and COMT, MAOA, and SLC6A4 polymorphisms were analyzed using a Real-Time PCR-based TaqMan genotyping assay. The association between genetic polymorphisms and the success of inferior alveolar nerve block was statistically evaluated.

Conditions

Symptomatic Irreversible Pulpitis (SIP)

Outcome Measures

Primary Outcomes (1)

• Success of Inferior Alveolar Nerve Block Anesthesia

  Anesthetic success was defined as an HP-VAS score of less than 54 mm during access cavity preparation and root canal treatment in patients with symptomatic irreversible pulpitis. An HP-VAS score of 54 mm or greater was considered anesthetic failure.

  During root canal treatment.

Study Arms (1)

Standard Inferior Alveolar Nerve Block

EXPERIMENTAL

Procedure: Inferior Alveolar Nerve Block with 4% Articaine

Interventions

Inferior Alveolar Nerve Block with 4% Articaine PROCEDURE

A standardized inferior alveolar nerve block was administered using 4% articaine with epinephrine to patients with symptomatic irreversible pulpitis in mandibular molars. Fifteen minutes after injection, pulpal anesthesia was evaluated using cold and electric pulp tests. Participants who continued to respond to either test were considered to have unsuccessful pulpal anesthesia and were excluded from the study. Root canal treatment was initiated in participants who showed no response to both tests. Pain experienced during treatment was assessed using the Heft-Parker Visual Analog Scale (HP-VAS). Anesthetic success was defined as an HP-VAS score of less than 54 mm, whereas an HP-VAS score of 54 mm or greater was considered anesthetic failure.

Standard Inferior Alveolar Nerve Block

Eligibility Criteria

• Age: 15 Years - 60 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Age between 15 and 60 years. American Society of Anesthesiologists (ASA) Physical Status I. Clinical diagnosis of symptomatic irreversible pulpitis in a mandibular molar requiring primary root canal treatment.
• Positive response to both the cold test and electric pulp test before treatment.
• Presence of pulpal bleeding upon access cavity preparation, confirming pulp vitality.
• Periodontal probing depth ≤3 mm. Sufficient coronal tooth structure to allow rubber dam isolation. No use of nonsteroidal anti-inflammatory drugs (NSAIDs) within 12 hours before enrollment.
• No known allergy or hypersensitivity to articaine or epinephrine. No history of systemic or genetic disease. Ability and willingness to provide written informed consent.

You may not qualify if:

• Previous endodontic treatment of the study tooth. Extensive coronal destruction preventing rubber dam isolation. Internal or external root resorption. Periodontal probing depth \>3 mm. Pregnancy or breastfeeding. Known allergy or hypersensitivity to articaine or epinephrine. Use of nonsteroidal anti-inflammatory drugs (NSAIDs) within 12 hours before enrollment.
• Presence of any systemic or genetic disease. Inability or unwillingness to provide written informed consent.

Sponsors & Collaborators

• Marmara University: lead

Study Sites (1)

Faculty of Dentistry, Marmara University

Istanbul, Istanbul, 34854, Turkey (Türkiye)

Location

MeSH Terms

Interventions

Carticaine

Intervention Hierarchy (Ancestors)

Thiophenes; Sulfur Compounds; Organic Chemicals; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds

Study Officials

• Nevin kartal, Prof.Dr

  Marmara University Faculty of Dentistry

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: All participants received the same standardized inferior alveolar nerve block using 4% articaine with epinephrine before endodontic treatment.

Study Record Dates

• First Submitted: July 5, 2026
• First Posted: July 13, 2026
• Study Start: November 12, 2025
• Primary Completion: April 2, 2026
• Study Completion: April 28, 2026
• Last Updated: July 14, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)