In a pioneering randomized controlled trial published in the “International Endodontic Journal”, researchers conducted a comparative analysis of anesthesia techniques for managing symptomatic irreversible pulpitis in mandibular molars. The trial was registered under NCT03802305, which focused on assessing cardiovascular effects and anesthetic efficacy of intraosseous computerized anesthesia (ICA) versus inferior alveolar nerve block (IANB).

The trial encompassed 72 mandibular molar teeth afflicted with symptomatic irreversible pulpitis.  The teeth were randomly assigned to get IANB injections (n=36) and ICA injections (n=36). Both techniques employed 1.8 mL of 4% articaine with 1: 100,000 epinephrine. The primary objective revolved around monitoring cardiovascular parameters throughout anesthesia, while the secondary goals involved comparing success rates and postoperative outcomes within a three-day period.

Results indicated no significant divergence in most cardiovascular parameters, with the exception of a greater heart rate increase in the ICA group compared to IANB. Other cardiovascular parameters did not reveal differences throughout the clinical procedure. There were no profound differences between groups in terms of anxiety, gender, or age. Moreover, ICA exhibited a notably higher total success rate (i.e. 91.43%) compared to IANB (69.44%), affirming its exceptional effectiveness.

The use of ICA was found to be safe and a remarkably efficient first-line option for treating symptomatic irreversible pulpitis in mandibular molars, as concluded. The higher success rate of ICA suggests that it may offer an improved alternative to the conventional IANB approach. Further research and clinical implementation of ICA could potentially boost patient experiences and outcomes in dental procedures involving pulpitis.