Clinical Research Directory

Inclusion Criteria: * Systemically healthy patients classified as ASA I, aged 18-55 years. * Permanent mandibular first molar tooth requiring endodontic therapy. * Diagnosed with symptomatic irreversible pulpitis without swelling or sinus. * Normal periapical radiographic appearance (no evidence of periapical pathology). * Moderate pain as assessed by the Heft-Parker VAS (\>54 mm and \<114 mm). * Lingering pain or prolonged response to cold testing (lasting more than 10 seconds). * Positive response to electric pulp testing. * Outcome assessed must be pulpal anesthesia Exclusion Criteria: * • Pregnant or lactating mothers. * Teeth with reversible pulpitis, previously treated, or with calcified canals. * Teeth with severe periodontal disease or periapical radiolucency. * Patients who have taken analgesics or anti-inflammatory drugs within 6 hours before the treatment visit. * Patients on medications that could potentially interact with the anesthetic solution (e.g., antihypertensives, anticoagulants). * History of allergy to 4% articaine, lidocaine, or epinephrine. * Systemic diseases, immunocompromised states, or significant anxiety/mental health disorders. * History of vasovagal syncope on local anesthetic administration