{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:18:21Z","timestamp":1791235101872,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Endodontic J"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to assess inferior alveolar nerve block (IANB) success of 2% mepivacaine (Scandonest 2%, Septodont, France) and 4% articaine (Septanest 4%, Septodont) in patients with symptomatic irreversible pulpitis (SIP) in mandibular molars during access cavity preparation and instrumentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>Three hundred and thirty patients with moderate\u2010to\u2010severe pain in mandibular molars with SIP randomly received either 3.6\u00a0ml 2% mepivacaine hydrochloride with 1:100\u2009000 adrenalin or 3.4\u00a0ml 4% articaine hydrochloride with 1:100\u2009000 adrenalin (<jats:italic>n<\/jats:italic>\u00a0=\u00a0165). Intraoperative pain (IOP) intensity was assessed during access cavity preparation and canal instrumentation using 11\u2010point Numerical Rating Scale (NRS). Overall success was considered if the patient felt no\u2010to\u2010mild pain without the need for supplemental anaesthesia throughout treatment; the incidence of need for supplemental anaesthesia was also recorded. Data were statistically analysed using Mann\u2013Whitney <jats:italic>U<\/jats:italic>\u2010 and Chi\u2010squared (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>) tests. Relative risk (RR) and 95% confidence interval (CI) of anaesthetic failure were calculated. The effect of pre\u2010disposing factors on outcome variables was assessed using multivariable regression analyses. None of the participants reported any adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline variables were balanced between groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05). The IOP intensity during access cavity preparation and canal instrumentation was similar for both groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05). IOP intensity was associated with preoperative pain intensity and tooth type (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Overall anaesthetic success rate was 35.8% for mepivacaine and 41.2% for articaine (<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05) with a relative risk of failure [95% CI] 1.09 [0.92, 1.30]. The need for supplemental anaesthesia occurred 43.6% and 38.2% with mepivacaine and articaine respectively (<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05; RR [95% CI]: 1.14 [0.88, 1.48]). Preoperative pain level and age were associated with the need for supplemental anaesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>2% mepivacaine and 4% articaine demonstrate similar IANB success rates for mandibular molars with SIP. Intraoperative pain experience during endodontic treatment can be associated with preoperative pain, tooth type and age.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iej.13810","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T14:39:43Z","timestamp":1660142383000},"page":"1177-1189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Inferior alveolar nerve block success of 2% mepivacaine versus 4% articaine in patients with symptomatic irreversible pulpitis in mandibular molars: A randomized <scp>double\u2010blind single\u2010centre<\/scp> clinical trial"],"prefix":"10.1111","volume":"55","author":[{"given":"Mohammed Fawzy Omar Mohammed","family":"Habib","sequence":"first","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sovana","family":"Tarek","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Mohamed Elsayed","family":"Teama","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Ezzat","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randa Mohamed","family":"El Boghdadi","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer","family":"Marzouk","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manar Yehia","family":"Fouda","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2884-6051","authenticated-orcid":false,"given":"Shaimaa Ismail","family":"Gawdat","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa\u00a0Mahmoud","family":"Bedier","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6229-9277","authenticated-orcid":false,"given":"Suzan Abdul Wanees","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2015.05.015"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2344\/15-00019.1"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.11607\/ofph.1642"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/iej.13328"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1590\/0103-6440201600663"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2344\/0003-3006-59.2.90"},{"key":"e_1_2_10_8_1","first-page":"70","article-title":"Mepivacaine: a closer look at its properties and current utility","volume":"62","author":"Brockmann W.G.","year":"2014","journal-title":"General Dentistry"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e7586"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/3108940"},{"key":"e_1_2_10_11_1","first-page":"22","article-title":"Comparison of the success rates of four anesthetic solutions for inferior alveolar nerve block in patients with irreversible pulpitis. 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