Is Bilateral Mental Incisive Nerve Block Better than Unilateral Mental Incisive Nerve Block during the Endodontic Management of Mandibular Incisors with Symptomatic Irreversible Pulpitis? A Prospective Single-blind Randomized Clinical Trial

Abstract

Introduction: The purpose of this clinical trial was to comparatively evaluate the anesthetic efficacy of unilateral and bilateral mental incisive nerve block (MINB) during the endodontic treatment of inflamed mandibular incisors.

Methods: The study was designed as a crossover single-blind study. A total of 76 patients requiring endodontic intervention in at least 2 mandibular incisors participated in this trial. The patients randomly received unilateral or bilateral MINB of 1.8 mL of 2% lidocaine with 1:80,000 epinephrine at 2 separate appointments. To blind the procedure, a saline injection was given on the contralateral side in the unilateral injections. The endodontic procedure was initiated in the incisors on the side of the first anesthetic injection. Patients with a negative response to electric testing received endodontic access opening under rubber dam. Patients were asked to report pain, if any, during the endodontic procedure by using a Heft-Parker visual analog scale. The anesthetic success was defined as no or mild pain on Heft-Parker visual analog scale (score, 0-54). The statistical analysis was performed with McNemar tests at P values <.05.

Results: The success rates of unilateral MINB and bilateral MINB were 38% and 64%, respectively, for the central incisors and 44% and 69%, respectively, for the lateral incisors. The difference was statistically significant (P < .05).

Conclusions: The bilateral MINB was more successful during the endodontic management of mandibular incisors with inflamed pulps. However, both the techniques failed to give 100% success rates.

Keywords: Lidocaine; mandibular incisors; mental/incisive nerve block.