The Effect of Acupuncture on the Success of Inferior Alveolar Nerve Block for Teeth with Symptomatic Irreversible Pulpitis: A Triple-blind Randomized Clinical Trial

Introduction: An inferior alveolar nerve block (IANB) does not always provide satisfactory anesthesia for patients with irreversible pulpitis. The aim of this study was to assess the effect of preoperative acupuncture on the success rate of IANBs for teeth with symptomatic irreversible pulpitis. Methods: In a randomized triple-blinded clinical trial, 40 patients with symptomatic irreversible pulpitis were divided into 2 groups: the acupuncture and control groups. In the acupuncture group, a disposable needle was inserted at LI4 (Hegu) acupoint, and after 15 minutes, for patients who had reported the De qi sensation, an IANB was administered. In the control group, 15 minutes before the administration of an IANB, the practitioner simply imitated the acupuncture procedure but did not actually insert the needle. Endodontic treatments were conducted for the patients who reported lip numbness 15 minutes after the injection of the IANB. If the patients felt intolerable pain (>20 mm on a visual analog scale of 100 mm) during the procedure, a supplementary injection was administered. In those situations, the IANB was considered an unsuccessful injection. Data were evaluated by the chi-square, Wilcoxon, Mann-Whitney, and t tests. The level of significance was set at 0.05. Results: The overall success rates of IANB for the acupuncture and control groups were 60% and 20%, respectively (P<.05). Conclusions: The application of acupuncture before the endodontic treatment increased the effectiveness of IANBs for mandibular molars with symptomatic irreversible pulpitis.