Two common local anesthetics for painful lower molars: lidocaine nerve block vs articaine cheek infiltration
Official title: Comparison of Anesthetic Efficacy OF 2% Lidocaine Inferior Alveolar Nerve (IANB) Block Versus Primary Buccal Infilteration With 4% Articaine in Symptomatic Irreversible Pulpitis(SIP) IN Mandibular First Molars
Run by Armed Forces Institute of Dentistry, Pakistan · NCT07409896 · Data updated 2026-11-12
This trial tests whether a lidocaine nerve block or a buccal infiltration with articaine provides better numbness for adults with painful lower first molars needing root canals.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years to 55 Years |
| Sex | All |
| Enrollment | 330 (estimated) |
| Sponsor | Armed Forces Institute of Dentistry, Pakistan Academic / other |
| Locations | 1 site (Rawalpindi, Punjab Province) |
| Status | Recruiting |
| Started | March 20, 2026 |
| Main results expected | November 20, 2026 |
| Study ends | December 20, 2026 |
| Registry record updated | October 27, 2026 |
| Trial ID | NCT07409896 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Systemically healthy adults aged 18-55 with symptomatic irreversible pulpitis of a mandibular first molar requiring endodontic therapy.
✕Probably not a fit
Patients with certain anatomical variations or anesthetic interactions, or those not achieving pulpal anesthesia, may not benefit.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This randomized, single-blind study compares two standard local anesthetic techniques in adults with symptomatic irreversible pulpitis of the mandibular first molar. Participants are assigned to receive either 2% lidocaine with epinephrine via inferior alveolar nerve block or 4% articaine with epinephrine via primary buccal infiltration, each delivered in 1.8 mL over 60 seconds. The primary outcome is pulpal anesthesia, assessed after 15 minutes, with topical benzocaine used beforehand and anxiety screened to minimize bias. The trial aims to determine which method yields more reliable pulpal anesthesia in a population with otherwise healthy systemic status. Results could influence choice of anesthesia technique in routine endodontic care for this condition.
Why it matters
Potential benefit: If successful, patients may experience more reliable numbness with a technique that is easier to perform or associated with fewer failures.
How similar studies have gone: Previous studies suggest articaine infiltration can provide effective anesthesia in similar contexts, but evidence in this specific adult population is limited.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Systemically healthy patients classified as ASA I, aged 18-55 years. * Permanent mandibular first molar tooth requiring endodontic therapy. * Diagnosed with symptomatic irreversible pulpitis without swelling or sinus. * Normal periapical radiographic appearance (no evidence of periapical pathology). * Moderate pain as assessed by the Heft-Parker VAS (\>54 mm and \<114 mm). * Lingering pain or prolonged response to cold testing (lasting more than 10 seconds). * Positive response to electric pulp testing. * Outcome assessed must be pulpal anesthesia Exclusion Criteria: * • Pregnant or lactating mothers. * Teeth with reversible pulpitis, previously treated, or with calcified canals. * Teeth with severe periodontal disease or periapical radiolucency. * Patients who have taken analgesics or anti-inflammatory drugs within 6 hours before the treatment visit. * Patients on medications that could potentially interact with the anesthetic solution (e.g., antihypertensives, anticoagulants). * History of allergy to 4% articaine, lidocaine, or epinephrine. * Systemic diseases, immunocompromised states, or significant anxiety/mental health disorders. * History of vasovagal syncope on local anesthetic administration
Where it's running
-
Armed Forces Institute of Dentistry AFID CMH Rawalpindi
Rawalpindi, Punjab Province, Pakistan Recruiting
Study contacts
- Study coordinator: Dr. Sadia Shehzadi Dr. Sadia Shehzadi, BDS,FCPS(PG3)
- Email: sadiashehzadi321@gmail.com
- Phone: 03342073051
How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.