A Combined 2% Lidocaine Anesthetic Technique for Mandibular Molar Procedures Without Inferior Alveolar Nerve Block

This prospective single-arm pilot study evaluated the clinical effectiveness of a combined local anesthetic technique using 2% lidocaine with 1:100,000 epinephrine for dental procedures involving mandibular molars. The technique combined supraperiosteal, subperiosteal, and periodontal ligament injections and was designed to provide adequate local anesthesia without the use of a conventional inferior alveolar nerve block. Participants requiring restorative, endodontic, extraction, or immediate implant procedures involving mandibular molars received the standardized anesthetic protocol. The primary outcome was successful completion of the planned dental procedure without pain requiring additional conventional nerve block anesthesia. The need for repeat administration and the occurrence of complications were also assessed.

Inclusion Criteria: * Patients aged 16-60 years. * Patients requiring dental treatment involving mandibular molars. * Patients requiring local anesthesia for the planned dental procedure. * Patients able and willing to provide informed consent. * For participants younger than 18 years, informed consent was obtained from a - parent or legal guardian. Exclusion Criteria: * Known allergy or hypersensitivity to lidocaine or epinephrine. * Medical conditions contraindicating the use of lidocaine with epinephrine. * Presence of acute infection or significant swelling at the injection site. * Patients unable to cooperate with the dental procedure or assessment of anesthetic effectiveness. * Patients who declined to participate or provide informed consent.