*7.1.3 Buccal infiltration*

After a failed IANB, buccal infiltration has been utilized as a supplemental anesthetic for anesthetizing mandibular molar teeth, especially in symptomatic irreversible pulpitis. A mandibular buccal infiltration injection of 4% articaine with 1:100,000 epinephrine as an additional injection to improve the effectiveness of the IANB injection has recently been investigated. The usage of the articaine solution was shown to be better than the lidocaine solution in asymptomatic individuals (88 percent vs. 71 percent, respectively) [37]. Only 58% anesthesia was achievable with buccal infiltration injection when used as a supplement to the IANB in case of symptomatic irreversible pulpitis [38].
