Abstract
BACKGROUND: The global prevalence of Diabetes Mellitus is steadily increasing, leading to a larger diabetic population undergoing root canal treatment (RCT). However, clinical studies assessing anesthetic success in diabetic patients are lacking. In diabetic patients, local anesthetic success may be affected owing to neurovasular changes in dental pulps. This study is intended to establish baseline data regarding local anesthetic success in the diabetic population undergoing RCT. The study's main purpose was to assess the success rate of Inferior Alveolar Nerve Block (IANB) in type 2 diabetic patients during RCT of mandibular molars with symptomatic irreversible pulpitis (SIP). METHODS: Sixty-five adult patients diagnosed with SIP in mandibular molars were divided into 2 groups according to their glycated hemoglobin (HbA1c) levels; control group (n = 31, HbA1c < 5.7) and diabetic group (n = 34, HbA1c levels > 6.5). After administering IANB and achieving lip numbness, endodontic access was initiated. Pain was recorded during endodontic procedure using Heft Parker visual analogue scale. Anesthetic success was defined as no or mild pain [score 0-54 mm] throughout endodontic procedure. Chi square test and Mann Whitney U tests were used for statistical analysis. RESULTS: Patients in the diabetic group exhibited significantly higher anesthetic success (94%) as compared to non-diabetic group (74%) (P = 0.016). Patients in the control group were significantly younger than the diabetic group (P < 0.001). Logistic regression revealed that tooth number was significantly associated with anesthetic success while age and gender had no significant influence on anesthetic success. CONCLUSIONS: Within the study limitations, IANB appeared more successful in diabetic patients compared to non-diabetics during RCT of mandibular molars with SIP. Studying local anesthetic success in diabetics is vital for enhancing patient comfort, safety and optimizing outcomes during RCT. TRIAL REGISTRATION: The clinical trial was registered on 24th September 2021 and registration no. is CTRI/2021/09/036813.