Evaluation of Systemic Inflammatory Index and Biomarkers in Relation to Inferior Alveolar Nerve Block Success and Postoperative Pain

Inclusion Criteria: * Patients aged between 18 and 65 years. Patients with a pain score greater than 54 on the Heft-Parker Visual Analog Scale (VAS). Patients classified as ASA I according to the American Society of Anesthesiologists (ASA). Teeth with probing depths less than 3 mm, suitable for rubber dam placement and restoration. Vital mandibular molar teeth with a clinical diagnosis of irreversible pulpitis, confirmed by pulp vitality tests (electric pulp testing and cold testing). Presence of bleeding upon access to the pulp chamber. No use of non-steroidal anti-inflammatory drugs (NSAIDs) within the last 12 hours. Absence of allergy to articaine. Patient's consent to provide a blood sample. Exclusion Criteria: * Patients classified as ASA II or higher. Pregnant women or those with suspected pregnancy. Patients with periodontal pockets greater than 3 mm in the involved tooth. Patients who received treatment with NSAIDs within the last 12 hours. Patients allergic to articaine. Teeth that had undergone previous endodontic treatment. Teeth with extensive structural loss preventing rubber dam isolation. Presence of internal or external root resorption.