Semester

Summer

Date of Graduation

2022

Document Type

Thesis

Degree Type

MS

College

School of Dentistry

Department

Not Listed

Committee Chair

Samuel O. Dorn

Committee Co-Chair

R. Constance Wiener

Committee Member

R. Constance Wiener

Committee Member

Mark A. Byron

Abstract

Introduction: Pain control during endodontic access is important to ensure patient comfort. Achieving adequate anesthesia in an acutely inflamed mandibular molar poses a treatment challenge as the reported failure rate is 30- 83%. A number of pre-medications, anesthetic techniques and adjuncts have been researched to determine their effect on the anesthetic success of the inferior alveolar nerve block (IANB). The purpose of this research was to describe the current clinical practices used by the members of the American Association of Endodontists in pain control of inflamed mandibular molars.

Methods: A cross-sectional observational study design was used. The study frame was the members of the American Association of Endodontists (n=5736). All members were invited to participate in the online survey about their treatment of acutely inflamed mandibular molars. Descriptive statistics and logistic regression analyses were conducted to compare practices of board- certified endodontists, board eligible endodontists, resident post graduate students and other endodontists who were neither board certified nor board eligible.

Results: There were 917 responses. Of all the techniques surveyed, buccal infiltration with 4% Articaine was most likely to be used 100% of the time to increase the success rate of the IANB. The use of a pre-medication before administering the IANB was reported as not likely due to the time considerations of both the patient and provider.

Conclusion: Although there are many techniques and adjuncts used to increase the success rate of the IANB in the literature, endodontists in clinical practice had adopted only a few. Additional qualitative research is needed determine reasons for the choices.

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