How should we anaesthetise painful mandibular premolars?

Design Randomised clinical trial Study population The present study evaluated patients of different genders aged between 18-65 years old. The study design and the language of the consent form were approved by the Ethics Committee at Tehran University of Medical Sciences (TUMS) (approval code: IR.TUMS.REC.1394.1906). The study was registered in the Iranian Registry of Clinical Trials. Data Analysis The evaluation was performed using the Heft-Parker Visual Analog Scale (HP VAS) and complemented with the electrical pulp test accuracy to determine the success of anaesthesia Results In this study, the success rate was 93.8% (95% CI 79.19-99.23) for mental/incisive nerve block (MINB), and 81.2% (95% CI 63.56-92.79) for inferior alveolar nerve block (IANB). The difference was not significant (p = 0.26). An interesting result was the combination of both techniques was 100% successful in the failed cases (2 in MINB group; 6 in IANB group). Conclusions In conclusion, MINB using 4% Articaine showed a similar success rate as IANB using 4% Articaine in local anaesthesia for mandibular premolars with irreversible pulpitis. The beginning of anaesthesia was faster for MINB, and the injection was painless. The post-injection pain for MINB was higher than for IANB. Both techniques showed similar efficacy.