The effect of auricular acupuncture on the success of inferior alveolar nerve block among patients with irreversible pulpitis in mandibular teeth

The effect of auricular acupuncture on the success of inferior alveolar nerve block in mandibular teeth with irreversible pulpitis

Randomized, double blind trial with control group and parallel group design

In the experimental group, ASP acupuncture needle will be inserted on acupuncture point for dental pain control and sticking plaster will be used on that. In control group a real puncture of needle will not happen and only sticking plaster will be used on points. 10 minutes after acupuncture, an endodontis will administer IANB injection in 60 seconds, based on a standard IANB method. After 15 minutes patients who will not report lip numbness will be excluded from study because this is a failed IANB. If they report lip numbness, endodontic procedure will be started. The patients will be instructed to report pain experienced during cavity preparation of dentin, exposure of pulp chamber and inserting initial file . Whenever a patient reports severe pain (>30 mm on VAS of 100 mm), a supplementary injection will be performed if they ask and that IANB will be considered unsuccessful. At the end of the endodontics procedure , the acupuncture’s ASPs will be removed.

Inclusion criteria: Patients who have a mandibular molar with irreversible pulpitis ,Between 18 and 65 years old. Non-inclusion criteria: Pregnancy; Systemic disease; Using alcohol, drug or smoking; taking any corticosteroid ,analgesic or antidepressant; sensitivity to lidocaine; periapical radiolucency.

In the experimental group,ASP acupuncture needle will be inserted on acupuncture point for dental pain control and sticking plaster will be used on that. In control group a real puncture of needle will not happen and only sticking plaster will be used on points.

Mandibular anesthesia

To randomize the patients, 56 papers will be numbered 1 to 56, and the first 28 papers will be placed individually in a red sealed envelope; the remaining 28 will be placed individually in a blue sealed envelope. Each female participant will be instructed to select a red sealed envelope, and each male participant will be asked to select blue one. Upon opening the envelopes, based on the number (odd numbers for the auricular acupuncture group and even numbers for the control group), they will be assigned to 1 of the 2 corresponding groups. This ensures an equal number of male and female participants per group.

Clinical observer: An instructed person will apply acupuncture, and a second investigator who is an endodontist administers IANB injection and endodontic procedure will be done. No one knows patients belong to which group , except who applies acupuncture so others are blind. Patient: In the acupuncture experimental group, the acupuncture points will be selected by acupuncture probe. An ASP acupuncture needle will be inserted at mentioned points on the side of the subjected tooth and sticking plaster will be used on that. In control group same points will be find by acupuncture probe but acupuncture needle will be inserted at other points which have no effect on dental pain and sticking plaster will be used on those points . At the end of the endodontics procedure , the acupuncture’s ASPs and sticking plasters will be removed so patients will not understand the difference and they are blind. The person who evaluates the result: The same person who accomplish endodontic procedure will ask about patient's pain during procedure(who is blind) and at last gives the result to the person who applies acupuncture (who is not blind) . Data analyzer: The person who analyzes data , will not know patients belong to which group and therefore he will be blind.