Objective: The purpose of this study is to determine the best possible combination of anaesthesia with articaine for achieving anaesthesia in mandibular molar teeth with symptomatic irreversible pulpitis. Materials and methods: A total of 18 patients with moderate to severe pain diagnosed with symptomatic irreversible pulpitis of mandibular posterior teeth were seleted. They were randomly assigned to one of the groups and received either an increased volume of articaine during procedure or 10mg of oral ketorolac one hour before the administration of IANB or 1ml of magnesium sulphate 50% IP one hour before the administration of IANB. The pain values were noted in HeftParker Visual analog scale before the procedure and during the access cavity preparation and the VAS scores were compared. Results: Inter group analysis was made using one way ANOVA test for the initial pain values and for the pain values during access cavity preparation. There was statistically significant difference in the pain value during access cavity preparation for the three groups (p=0.0365) with the least pain value for oral ketorolac group. Conclusion: Under the conditions of this study it can be concluded that, combination of articaine with pre-operative oral ketorolac provided significant decrease in pain during endodontic procedure followed by combination with pre-operative magnesium sulphate and increased volume of articaine.
