Anesthetic Efficacy of Lignocaine Added with Magnesium Sulfate during Pulpectomy in Children with Irreversible Pulpitis: A Prospective, Split-mouth, Randomized Controlled Trial.

AIM AND BACKGROUND: Pain control is one of the major challenges of pediatric dentistry. Pain control after an inferior alveolar nerve block (IANB) during pulpectomy is often challenging in pediatric patients. Hence, this study aims to investigate the effect of addition of magnesium sulfate (MgSO4) to lignocaine hydrochloride on pulpal anesthesia achieved after administration of IANB for pulpectomy in children with irreversible pulpitis. METHODS: 32 patients fulfilling the inclusion criteria were selected in this split-mouth study design. Patients received either test or control solutions at two different appointments as an inferior alveolar nerve block. The test solution contains MgSO4 added to lignocaine hydrochloride, whereas the control solution contains sterile water added to lignocaine hydrochloride. Pain assessment was performed using the Heft-Parker visual analog scale (HP-VAS) and the faces, legs, activity, cry, and consolability (FLACC) scales. Comparison of variables was done using a paired t-test and a Wilcoxon signed-rank test. RESULTS: Pain scores recorded in the test side were significantly lower compared to those recorded in the control side during access opening (FLACC scores on the test side and control side were 2.00 ± 0.76 and 2.47 ± 0.62; HP-VAS scores in the test and control side were 25.72 ± 5.75 and 28.44 ± 5.64). Pain scores during pulp extirpation are: HP-VAS on the test side is 36.68 ± 1.07, and on the control side is 55.74 ± 1.69; FLACC scores on the test and control sides are 2.05 ± 0.94 and 2.61 ± 0.57, respectively. CONCLUSION: Magnesium sulfate, when added to lignocaine local anesthesia (LA), was successful in enhancing the depth of pulpal anesthesia. CLINICAL SIGNIFICANCE: Addition of magnesium sulfate enhances the depth of local anesthesia while treating primary teeth with chronic irreversible pulpitis.