Can postanesthetic cold sensibility test be used as a tool for the efficacy of inferior alveolar nerve block in patients with symptomatic irreversible pulpitis of mandibular molars? – In vivo study

Abstract

Objectives: The goal of this investigation was to determine the efficiency of a postanesthetic cold test for the detection of pulpal anesthesia to improve diagnostic accuracy. Materials and Methods: Fifty-two participants who showed symptomatic irreversible pulpitis on the mandibular first molar, aged from 18 to 65 years, were given inferior alveolar nerve block (IANB), and subjective anesthetic symptoms were seen after 15 min and were finally assigned for studies. To determine the effectiveness of a postanesthetic cold test for the detection of pulpal anesthesia, the target tooth was separated and Endo-Frost was utilized to conduct a postanesthetic cold sensibility test and was compared to the gold standard test, painful or painless sensation during actual root canal therapy. Of 52 participants, 9 had a positive response to the postanesthetic cold test and 43 had a negative response; 10 responded positively to the gold standard test, whereas 42 gave negative results. Results: The postanesthetic cold sensibility test can diagnose the effectiveness of pulp anesthesia showing a sensitivity of 80%, specificity of 97.62%, positive likelihood ratio of 33.6, negative likelihood ratio of 0.2, positive predictive value of 88.89%, negative predictive value of 95.35%, accuracy of 94.23%, and Youden’s index of 0.78. Conclusions: The postanesthetic cold sensibility test can be used as a tool for the efficiency of IANB before starting root canal therapy to minimize pain and anxiety in patients.