IRCT2012110510866N1 IRCT 2012-11-05 Azad University of Khorasgan-ُSchool of Dentistry- X-tip intraosseous injection system as a primary anesthesia for irreversible pulpitis of posterior mandibular teeth X-tip intraosseous injection system as a primary anesthesia for irreversible pulpitis of posterior mandibular teeth 2012-09-01 anticipated 40 Complete https://irct.ir/trial/11285 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Other design features: Successful anesthesia during root canal therapy may be difficult to obtain. Intraosseous injection significantly improves anesthesia's success as a supplemental pulpal anesthesia, particularly in cases of irreversible pulpitis. N/A Irreversible pulpitis. Intervention 1: A single clinician performed all procedures, including diagnosis, injection, and anesthesia evaluation. For the first group, the X-tip intraosseous injection was done according to the manufacturer’s instructions; after evaluating root proximity by radiography, perforation site was located in alveolar mucosa at the distal site of the first molars or at the mesial site of the second molars. A volume of (0.1 ml) 2% lidocaine with 1:100,000 epinephrine (Darou pakhsh, Tehran, Iran) was infiltrated through a 30 gauge needle at the perforation site before intraosseous injection. The perforator drill position was 90-degree angle to the cortical bone and the slow-speed hand piece was activated in a series of short bursts, using light pressure until 2 to 5 seconds had passed. The needle was then engaged in a pen-gripping fashion and 1.8 ml of 2% lidocaine with 1:100,000 epinephrine was injected slowly during 60 seconds. Before inserting the 27 gauge ultrashort X-tip needle into the guide sleeve, the needle was bent with a 60 to 80 degree angle to allow the easy insertion. The perforator was pushed through the alveolar mucosa until the X-tip faced bone. Intervention 2: One healthy Contralateral tooth in the same jaw served as negative control and received no anesthesia and was tested by endo Ice and electric pulp tester. A single clinician performed all procedures, including diagnosis, injection, and anesthesia evaluation. In the second group, the IAN block was performed by standard technique. The IAN block group received the same type and volume of anesthetic solution.