x‑tip intraosseous injection system as a primary anesthesia forirreversible pulpitis of posterior mandibular teeth: a randomizedclinical trail

background: successful anesthesia during root canal therapy may be difficult to obtain. intraosseousinjection significantly improves anesthesia’s success as a supplemental pulpal anesthesia, particularly incases of irreversible pulpitis. the aim of this study was to compare the efficacy of x‑tip intraosseousinjection and inferior alveolar nerve (ian) block in primary anesthesia for mandibular posteriorteeth with irreversible pulpitis. materials and methods: forty emergency patients with an irreversible pulpitis of mandibular posterior teeth were randomly assigned to receive either intraosseous injection using the x‑tipintraosseous injection system or ian block as the primary injection method for pulpal anesthesia.pulpal anesthesia was evaluated using an electric pulp tester and endo ice at 5‑min intervals for15 min. anesthesia’s success or failure rates were recorded and analyzed using spss version 12statistical software. success or failure rates were compared using a fisher’s exact test, and thetime duration for the onset of anesthesia was compared using mann–whitney u test. p < 0.05was considered significant. results: intraosseous injection system resulted in successful anesthesia in 17 out of 20 patients(85%). successful anesthesia was achieved with the ian block in 14 out of 20 patients (70%).however, the difference (15%) was not statistically significant ( p = 0.2). conclusion: considering the relatively expensive armamentarium, probability of penetrator separation, temporary tachycardia, and possibility of damage to root during drilling, the authorsdo not suggest intraosseous injection as a suitable primary technique. key words: anesthesia, intraosseous injection, irreversible pulpitis