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Abstract
The purpose of the present study was to assess effect of 4% articaine infiltration versus 2% lidocaine nerve block after premedication by ibuprofen on anesthetic efficacy in endodontic treatment of first permanent molar with acute irreversible pulpitis, in a randomized, single-blind study. Results: There was no statistically significant difference in percent of successful cases between lidocaine (53.8%, 76.9%) and articaine groups (50%, 57.7%) in access and cleaning and shaping, respectively. There was no statistically significant difference in number of patients needed supplemental intrapulpal anesthesia. Most patients reported no or mild pain after 24 hours in both groups and only one tablet was taken when needed. Conclusions: lidocaine inferior alveolar nerve block (IANB) is similar to articaine infiltration in mandibular molars with acute irreversible pulpitis, thus making infiltration with articaine a viable alternative to IANB. Furthermore, supplemental intrapulpal anesthesia proved to be an effective method in controlling pain and finalizing treatment successfully.