In a single-blind, randomized clinical trial published in "Clinical Oral Investigations", the success of pulpal anesthesia was significantly enhanced by augmenting the volume of Articaine through the use of two cartridges for infiltration in maxillary first molars with irreversible pulpitis. Furthermore, the addition of palatal infiltration to buccal infiltration contributed to the improved efficacy of the anesthesia. The objective was to examine the efficacy of two different approaches to pulpal anesthesia using 4% Articaine infiltration.

In this study, 45 patients with symptomatic irreversible pulpitis in their maxillary first molars were enrolled. Participants were divided into three groups. Group 1 received 1.8 mL (one cartridge) of Articaine with 1:100,000 epinephrine via buccal infiltration, Group 2 received 3.6 mL (two cartridges) of Articaine via buccal infiltration, and Group 3 received 1.8 mL of Articaine via buccal infiltration plus 0.5 mL of Articaine via palatal infiltration. The pain intensity experienced during injection and access cavity preparation was assessed using the Heft-Parker visual analog scale (VAS).

Successful anesthesia was defined as the absence of pain or only mild pain during treatment.

Analysis of data was done with the aid of Tukey's post hoc test. There was a considerable difference in pain frequency during injection among the three groups. A higher volume of 4% Articaine and the combination of buccal and palatal infiltrations resulted in a remarkably higher success rate of anesthesia. Group 3, which received the combined infiltration approach, demonstrated the highest success rate followed by Group 2 and Group 1, as shown in Table 1:

Hence, attaining deep anesthesia in teeth with irreversible pulpitis is crucial for effectively managing patients requiring urgent root canal treatments.