ENDODONTIC ANESTHESIA IN MANDIBULAR MOLARS - A CLINICAL-STUDY

Sixty-one mandibular molar teeth with clinically manifest pulpitis, wh ich required endodontic therapy, were studied. Twenty-seven subjects r eceived standard inferior alveolar nerve block (IANB) with 2% lidocain e HCI with 1:100,000 epinephrine and 34 subjects received IANB with 3% mepivacaine with no vasoconstrictor. Pulpal anesthesia was assessed w ith dichlorodifluormethane (DDM). Subjects who gave a positive respons e to DDM were given a periodontal ligament injection with 2% lidocaine with 1:100,000 epinephrine. This study showed that 3% mepivacaine HCl is as effective as 2% lidocaine HCl in achieving pulpal anesthesia in mandibular molars with IANB. Of a total 61 IANB with lip anesthesia, 23 subjects required peridontal ligament injection to achieve a negati ve response to DDM. It was concluded that lip anesthesia is not a reli able indicator of pulpal anesthesia. The use of DDM is a reliable meth od of determining true pulpal anesthesia.