{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:23:44Z","timestamp":1787840624108,"version":"build-2784847793"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>No consensus has been reached on the effect of topical application of amitriptyline and nortriptyline on irreversible pulpitis pain in teeth with failed pulpal anesthesia after a successful inferior alveolar nerve (IAN) block. This study aimed to assess the effect of topical application of amitriptyline and nortriptyline on irreversible pulpitis pain in teeth with failed pulpal anesthesia after a successful IAN block.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      This double-blind randomized controlled clinical trial was conducted on 45 patients with irreversible pulpitis. The patients were randomly assigned to three groups (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 15) for topical application of 10 mg amitriptyline, 10 mg nortriptyline, and starch (placebo). An IAN block was primarily administered by injection of lidocaine with 1:80,000 epinephrine. Next, the abovementioned medications were topically applied in each group. The pain level of patients was quantified by the McGill Visual Analog Scale (VAS) and the Wong\u2013Baker Faces Pain Rating Scale (FPRS) before the intervention, immediately after injection, and after topical application of materials and compared. Data were analyzed by SPSS version 21 using the Chi-square test, likelihood ratio, one-way ANOVA, repeated-measures ANOVA, and the Kruskal\u2013Wallis test.\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      All three interventions significantly decreased pain (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Although nortriptyline caused a greater pain relief, the difference among the three groups was not significant regarding the VAS or Wong\u2013Baker FPRS scores (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although nortriptyline caused a greater reduction in irreversible pulpitis pain than amitriptyline, the difference between the two medications was not significant. Future studies without a placebo group are recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/drj.drj_324_23","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T01:01:08Z","timestamp":1732150868000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Effect of topical application of amitriptyline and nortriptyline on irreversible pulpitis pain in teeth with failed pulpal anesthesia after a successful inferior alveolar nerve block: A randomized clinical trial"],"prefix":"10.4103","volume":"21","author":[{"given":"Armita","family":"Vali Sichani","sequence":"first","affiliation":[{"name":"Department of Endodontics, Dental Materials Research Center, School of Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Baharian","sequence":"additional","affiliation":[{"name":"Dental Research Center, Dental Students\u2019 Research Committee, Department of Endodontics, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navid","family":"Yaraghi","sequence":"additional","affiliation":[{"name":"Orthodontic in Private Clinic, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Khosravani","sequence":"additional","affiliation":[{"name":"Department of Endodontics, School of Dentistry, Bushehr University of Medical Sciences, Bushehr, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asana Vali","family":"Sichani","sequence":"additional","affiliation":[{"name":"School of Dental Medicine, Boston University Henry. 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