{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:26:57Z","timestamp":1783423617556,"version":"3.54.6"},"reference-count":42,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p>The aim of this study was to provide an evidence-based answer to the question: \u201cIs 3.6-mL volume of an anesthetic agent more effective than 1.8-mL volume in providing anesthesia for mandibular molars?\u201d Following formulation of research question and keyword selection, a comprehensive search of the following databases was conducted: Cochrane library, PubMed, Scopus, Google Scholar, ProQuest, and Clinicaltrials.gov. Three-phase eligibility appraisal and quality assessment of the studies were carried out by 2 independent reviewers. To reduce clinical heterogeneity, the included studies were divided into 2 groups: studies on healthy teeth and studies on teeth with pulpitis. The data of included studies were statistically combined through meta-analysis using a fixed-effects model. A total of 20,778 records were initially retrieved from the search. Following screening and eligibility assessment, 8 studies met the eligibility criteria and were included for qualitative synthesis. Of those, 5 studies were qualified for meta-analysis. In the irreversible pulpitis group, increasing the volume of anesthetic agent from 1.8 to 3.6 mL significantly increased the success rate of inferior alveolar nerve block (risk ratio = 2.45, 95% CI: 1.67\u20133.59, <jats:italic>p<\/jats:italic> &lt; .001). However, there was insufficient evidence to draw a conclusion regarding healthy teeth.<\/jats:p>","DOI":"10.2344\/anpr-65-01-03","type":"journal-article","created":{"date-parts":[[2018,3,6]],"date-time":"2018-03-06T17:21:07Z","timestamp":1520356867000},"page":"16-23","source":"Crossref","is-referenced-by-count":24,"title":["Volume of Anesthetic Agents and IANB Success: A Systematic Review"],"prefix":"10.2344","volume":"65","author":[{"given":"Amin Salem","family":"Milani","sequence":"first","affiliation":[{"name":"Assistant Professor, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Froughreyhani","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed","family":"Rahimi","sequence":"additional","affiliation":[{"name":"Professor of Endodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vahid","family":"Zand","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Asghari","family":"Jafarabadi","sequence":"additional","affiliation":[{"name":"Associate Professor of Biostatistics, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"key":"i0003-3006-65-1-16-b01","series-title":"Int Endod J","first-page":"238","article-title":"Articaine buccal infiltration enhances the effectiveness of lidocaine inferior alveolar nerve block","volume":"42","author":"Kanaa \n              MD,","year":"2009","unstructured":"Kanaa \n              MD, \n            \n            \n              Whitworth \n              JM, \n            \n            \n              Corbett \n              IP, \n            \n            \n              Meechan \n              JG. \n            \n          \n          Articaine buccal infiltration enhances the effectiveness of lidocaine inferior alveolar nerve block. 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Gen Dent. 2002;50:372\u2013375; quiz 376\u2013377."},{"key":"i0003-3006-65-1-16-b04","series-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod","first-page":"132","article-title":"Anesthetic efficacy of unilateral and bilateral inferior alveolar nerve blocks to determine cross innervation in anterior teeth","volume":"92","author":"Yonchak \n              T,","year":"2001","unstructured":"Yonchak \n              T, \n            \n            \n              Reader \n              A, \n            \n            \n              Beck \n              M, \n            \n            \n              Meyers \n              WJ. \n            \n          \n          Anesthetic efficacy of unilateral and bilateral inferior alveolar nerve blocks to determine cross innervation in anterior teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92:132\u2013135."},{"key":"i0003-3006-65-1-16-b05","series-title":"J Endod","first-page":"753","article-title":"Comparative evaluation of 1.8 mL and 3.6 mL of 2% lidocaine with 1:200,000 epinephrine for inferior alveolar nerve block in patients with irreversible pulpitis: a prospective, randomized single-blind study","volume":"38","author":"Aggarwal \n              V,","year":"2012","unstructured":"Aggarwal \n              V, \n            \n            \n              Singla \n              M, \n            \n            \n              Miglani \n              S, \n            \n            \n              Kohli \n              S, \n            \n            \n              Singh \n              S. \n            \n          \n          Comparative evaluation of 1.8 mL and 3.6 mL of 2% lidocaine with 1:200,000 epinephrine for inferior alveolar nerve block in patients with irreversible pulpitis: a prospective, randomized single-blind study. 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J Endod. 2009;35:343\u2013346."},{"key":"i0003-3006-65-1-16-b09","series-title":"J Endod","first-page":"925","article-title":"Anesthetic efficacy of supplemental buccal and lingual infiltrations of articaine and lidocaine after an inferior alveolar nerve block in patients with irreversible pulpitis","volume":"35","author":"Aggarwal \n              V,","year":"2009","unstructured":"Aggarwal \n              V, \n            \n            \n              Jain \n              A, \n            \n            \n              Kabi \n              D. \n            \n          \n          Anesthetic efficacy of supplemental buccal and lingual infiltrations of articaine and lidocaine after an inferior alveolar nerve block in patients with irreversible pulpitis. 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Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:303\u2013308."},{"key":"i0003-3006-65-1-16-b11","series-title":"Endod Dent Traumatol","first-page":"247","article-title":"Failure of inferior alveolar nerve block in endodontics","volume":"15","author":"Potocnik \n              I,","year":"1999","unstructured":"Potocnik \n              I, \n            \n            \n              Bajrovic \n              F. \n            \n          \n          Failure of inferior alveolar nerve block in endodontics. Endod Dent Traumatol. 1999;15:247\u2013251."},{"key":"i0003-3006-65-1-16-b12","series-title":"Endod Topics","first-page":"26","article-title":"Local anesthetic failure in endodontics","volume":"1","author":"Hargreaves \n              KM,","year":"2002","unstructured":"Hargreaves \n              KM, \n            \n            \n              Keiser \n              K. \n            \n          \n          Local anesthetic failure in endodontics. Endod Topics. 2002;1:26\u201339."},{"key":"i0003-3006-65-1-16-b13","series-title":"J Endod","first-page":"1408","article-title":"A comparison of different volumes of articaine for inferior alveolar nerve block for molar teeth with symptomatic irreversible pulpitis","volume":"41","author":"Abazarpoor \n              R,","year":"2015","unstructured":"Abazarpoor \n              R, \n            \n            \n              Parirokh \n              M, \n            \n            \n              Nakhaee \n              N, \n            \n            \n              Abbott \n              PV. \n            \n          \n          A comparison of different volumes of articaine for inferior alveolar nerve block for molar teeth with symptomatic irreversible pulpitis. 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J Endod. 2010;36:1459\u20131462."},{"key":"i0003-3006-65-1-16-b16","series-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod","first-page":"468","article-title":"Efficacy of combining a buccal infiltration with an inferior alveolar nerve block for mandibular molars with irreversible pulpitis","volume":"109","author":"Parirokh \n              M,","year":"2010","unstructured":"Parirokh \n              M, \n            \n            \n              Satvati \n              SA, \n            \n            \n              Sharifi \n              R, \n            \n            et al. \n          Efficacy of combining a buccal infiltration with an inferior alveolar nerve block for mandibular molars with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:468\u2013473."},{"key":"i0003-3006-65-1-16-b17","series-title":"J Endod","first-page":"575","article-title":"Evaluation of lidocaine in human inferior alveolar nerve block","volume":"23","author":"Yared \n              GM,","year":"1997","unstructured":"Yared \n              GM, \n            \n            \n              Dagher \n              FB. \n            \n          \n          Evaluation of lidocaine in human inferior alveolar nerve block. J Endod. 1997;23:575\u2013578."},{"key":"i0003-3006-65-1-16-b18","series-title":"J Endod","first-page":"178","article-title":"An evaluation of 2% lidocaine with different concentrations of epinephrine for inferior alveolar nerve block","volume":"23","author":"Dagher \n              FB,","year":"1997","unstructured":"Dagher \n              FB, \n            \n            \n              Yared \n              GM, \n            \n            \n              Machtou \n              P. \n            \n          \n          An evaluation of 2% lidocaine with different concentrations of epinephrine for inferior alveolar nerve block. J Endod. 1997;23:178\u2013180."},{"key":"i0003-3006-65-1-16-b19","series-title":"J Endod","first-page":"970","article-title":"Is a volume of 3.6 mL better than 1.8 mL for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis?","volume":"39","author":"Fowler \n              S,","year":"2013","unstructured":"Fowler \n              S, \n            \n            \n              Reader \n              A. \n            \n          \n          Is a volume of 3.6 mL better than 1.8 mL for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis?\n          J Endod. 2013;39:970\u2013972."},{"key":"i0003-3006-65-1-16-b20","series-title":"J Clin Epidemiol","first-page":"1006","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"62","author":"Moher \n              D,","year":"2009","unstructured":"Moher \n              D, \n            \n            \n              Liberati \n              A, \n            \n            \n              Tetzlaff \n              J, \n            \n            \n              Altman \n              DG. \n            \n          \n          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. 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