Efficacy of the TuttleNumbNow Intraosseous Method for Pulpal Anesthesia in the Mandibular First Molar - A Prospective, Randomized, Crossover Study.

Previous studies on intraosseous (IO) anesthesia as a primary injection have shown high success rates. The TuttleNumbNow (TNN) is a new primary IO injection technique that has not been scientifically evaluated. Therefore, the purpose of this prospective randomized, crossover, study was to evaluate the anesthetic efficacy of the TNN IO technique using the Septoject Evolution needle when compared to a buccal infiltration for pulpal anesthesia in the mandibular first molar. One-hundred and four healthy subjects were randomly assigned to two treatment groups, separated by at least two weeks. One set of injections consisted of a buccal infiltration of the mandibular first molar using 1.8 mL of 4% articaine with 1:100,000 epinephrine, followed by a mock TNN injection distal to the mandibular first molar. The other set of injections was a mock buccal infiltration of the mandibular first molar, followed by a TNN injection of 1.8 mL of 4% articaine with 1:100,000 epinephrine distal to the mandibular first molar. Statistical analyses were performed. For the mandibular first molar, which had a 42% anesthetic success (highest 80 reading) with the buccal infiltration compared to 49% with the TNN, no statistically significant difference in success was observed (p=0.2115). The TNN technique has been advocated as an intraosseous injection. However, the inability to deliver anesthetic solution to the cancellous bone resulted in an anesthetic success rate of 49%. The success was statistically similar to a buccal infiltration (42%) and would not provide adequate pulpal anesthesia as a primary injection.

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