Inclusion criteria:
Patients requiring root canal therapy have signs and symptoms of irreversible pulpitis in the mandibular first and second molars in whom a mandibular nerve block anesthetic injection has not been successful and who have pain during access cavity preparation.
Requires intra pulpal injection
Has systemic health
Signing a written and informed consent form
Cold testing using EndoFrost will be performed on the mandibular first and second molars and the contralateral tooth. Teeth that respond positively will be included in the study.
Teeth with moderate, sharp, and spontaneous pain, a preoperative VAS score greater than 5, or pain stimulated by heat or cold that persisted after removal of the stimulus, without pain on biting or tapping, and without periapical changes or lesions (periapical index ≤2) will be included in the study.
Exclusion criteria:
Teeth with crown/root fractures, acute or chronic apical abscess, necrosis, damaged periodontium, or open apex
Presence of physical disability, mental problems, or facial paresthesia (tingling or numbness)
History of sensitivity to local anesthetic solutions
Patients who have had a history of taking long-term medications that affect pain threshold, such as painkillers, steroids, or antibiotics, in the past 24 hours
Teeth that are observed as non-vital during access cavity preparation