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Aim: To establish the effects of submucosal tramadol, dexamethasone and articaine on the success of inferior alveolar nerve blocks (IANB) during root canal treatment of mandibular molars with symptomatic irreversible pulpitis (SIP). Methodology: In this randomized double‐blind, controlled clinical trial, 120 patients with the diagnosis of SIP in their mandibular first or second molars were included and randomly divided into four groups (n = 30). The control group received normal saline and three experimental groups received a single dose of dexamethasone (8 mg/2 mL), or tramadol (100 mg/2 mL) or articaine (4% / 2 mL). The pre‐operative pain levels of the patients were measured with the Heft‐Parker visual analogue scale (HP VAS). All patients received standard IANB of 4% articaine with 1:200000 epinephrine. Following the observation of lip numbness, submucosal injections were administered into the mucobuccal fold adjacent to the mandibular molars. After 15 min, standard root canal treatment was initiated, and the pain intensity levels recorded from the access cavity preparation to pulp extirpation were measured with HP VAS. The duration of the anaesthesia was also evaluated. The experimental groups were compared using one‐way ANOVA or Kruskal–Wallis H‐test. The groups that were significantly different were compared pairwise using the Tukey Multiple Comparison test. The Chi‐square test was used to compare the categorical variables. Results: The submucosal administration of articaine significantly increased the success rate to 63% in comparison with the control group that received submucosal saline (p <.05). The success rate of pulpal anaesthesia was 37% in the control group, 57% in the tramadol group and 47% in the dexamethasone group, with no significant difference in the success rate among these groups. In the dexamethasone group, the duration of the anaesthetic effect of IANB was significantly longer than those in the other groups (p <.001). Conclusions: In patients with SIP, pre‐operative submucosal administration of articaine increased the success rate of IANB, while administration of dexamethasone increased the duration of anaesthesia. These agents can be used in cases where effective anaesthesia cannot be obtained during root canal treatments. [ABSTRACT FROM AUTHOR]

The aim of the present study is to compare the efficacy of additional 100 mg/2 ml tramadol and 40 mg/2 ml lidocaine applications on the anesthetic success of inferior alveolar nerve block (IANB) in mandibular molars with symptomatic irreversible pulpitis (MM-SIP). One hundred and five patients diagnosed with symptomatic pulpitis in the lower first or second molars were included in the study. Patients were randomly divided into three groups (n = 35) composed of control and two experimental groups administered submucosal tramadol and lidocaine. Preoperative pain levels of the patients were measured with Heft-Parker visual analog scale (HP VAS). Following, standard IANB with 2% lidocaine 1: 80,000 was administrated to all groups. After observation of lip numbness, 2 ml of saline in the control group, 100 mg/2 ml tramadol in tramadol group and 40 mg/2 ml (2%, 1: 80,000) lidocaine in lidocaine group were administered submucosally. After 15 min, standard endodontic treatment was initiated and the pain levels measured from access cavity preparation to pulp extirpation were measured with HP VAS. The success rate of pulpal anesthesia was 28.5% in the control group, 45.7% in the submucosal lidocaine group and 48.6% in the tramadol group. There was no statistically significant difference in the success rate between the groups. Additional submucosal administration of 100 mg tramadol did not significantly increase the success of IANB applied with a combination of 2% lidocaine 1:80,000 and epinephrine in MM-SIP compared to control group. [ABSTRACT FROM AUTHOR]

Radicular cysts are inflammatory jaw cysts that form in the apices of infected and necrotic pulp teeth. They are usually asymptomatic and tend to grow slowly. However, depending on the progressive size of the lesion and its relation to neighboring tissues, it may cause mobility, root resorption and displacement. In addition, a limited number of studies have been reported in which paresthesia occurs as a result of local pressure caused by periapical pathology and various mandibular intraosseous lesions on nerve tissue. In this study, treatment process of the paresthesia of inferior alveolar nerve caused by radicular cyst which is remained asymptomatic for a long time in the left posterior mandible is presented in a 33 year-old male patient and it is evaluated in the light of current literature. [ABSTRACT FROM AUTHOR]