The goal of this clinical trial is to systematically compare the pain scores and anesthesia efficacy of IANB and MNB in the treatment of symptomatic mandibular first and second premolars. This study aims to address gaps in current evidence and clarify whether these anesthesia techniques differ in effectiveness and patient experience during endodontic procedures. The hypotheses include: (i) no difference in pain perception between IANB and MNB, (ii) no difference between first and second premolars with IANB, and (iii) no difference between first and second premolars with MNB.
Who can participate
Age range
18 Years – 65 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Individuals classified as ASA 1 or ASA 2.
* Age range of 18 to 65 years.
* No known allergies to articaine or epinephrine.
* Absence of facial paresthesia.
* No use of analgesic medications within 6 hours prior to treatment.
* No use of medications, such as tricyclic antidepressants or beta blockers, that may interfere with anesthesia.
* No pathological conditions at the planned injection site.
* Periodontal pocket depth of 3 mm or less.
* Mandibular first or second premolars diagnosed with symptomatic irreversible pulpitis.
* Teeth meeting Glickman's gingival health criteria upon periodontal examination.
* Radiographically closed root apex with no detectable pathology.
* Patients must be literate and able to comprehend the use of a pain scale to provide informed consent voluntarily.
Exclusion Criteria:
* Presence of systemic conditions contraindicating endodontic treatment. Age below 18 or above 65 years.
* Pregnancy.
* Documented allergy to articaine with 1:100,000 epinephrine.
* Evidence of periapical pathology or radiolucency observed in radiographs.
* Recent use of central nervous system depressants or analgesic medication within 6 hours prior to treatment.
* Absence of reported lip numbness 10 minutes following IANB or MINB injection. Presence of a large restoration on the affected tooth.
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
What they're measuring
1
Numerical Rating Scale
Timeframe: Following anesthesia administration, a 10-minute waiting period was observed. Patients completed a Numerical Rating Scale immediately upon initiation of the endodontic cavity procedure and again after the start of pulp extirpation.