Anesthetic efficacy of the supplemental intraosseous injection for teeth with irreversible pulpitis

The purpose of this study was to determine the efficacy of a supplemental i ntraosseous injection (IOI) of 2% lidocaine with 1:100,000 epinephrine usin g the Stabident device, after conventional anesthetic methods had failed. P atients who experienced pain during endodontic access and required a supple mental IOI using 0.45 to 0.90 ml of the local anesthetic were identified. A ll 37 of the patients treated had teeth diagnosed with irreversible pulpiti s. Thirty-four of the teeth were mandibular posterior teeth, 2 were maxilla ry posterior teeth, and 1 was a maxillary anterior tooth. Patients with max illary teeth had received infiltration anesthesia, and those with mandibula r teeth had received an inferior alveolar nerve block in conjunction with l ong buccal infiltration. A minimum of 3.6 ml of local anesthetic was used w ith the conventional techniques. Modified visual analogue scales, coupled w ith operator evaluations, were used to measure success. The Stabident IOI w as an effective supplemental anesthetic technique in 89% (+/-5.1) or 33/37 patients evaluated. The 95% confidence interval was 74 to 97%. The IOI was successful in 91% (+/-4.9) of the mandibular posterior teeth (31/34), and 6 7% of the maxillary teeth (2/3).