Study of SCN9A Gene Expression and Inflammatory Cytokines Affecting Success of Inferior Alveolar Nerve Block in Adults with Symptomatic Irreversible Pulpitis

What this Trial Is About

Researchers are investigating how the expression of the SCN9A gene, which codes for a sodium channel involved in pain transmission, and levels of inflammatory cytokines relate to the success of inferior alveolar nerve block IANB anesthesia in patients with symptomatic irreversible pulpitis SIP affecting mandibular molars. The study is a prospective case-control design enrolling about 90-100 patients to understand why anesthesia sometimes fails during dental procedures despite standard treatment. Understanding these molecular and inflammatory factors may help improve anesthetic outcomes in endodontics. All participants will receive a standardized IANB using 2% lidocaine with 1100,000 epinephrine administered by a conventional technique. Patients will be grouped based on whether anesthesia is successful or fails, determined by their pain experience during access cavity preparation and initial instrumentation. After confirming anesthesia status, dental pulp tissue samples will be collected for molecular analysis, including SCN9A gene expression measured by quantitative real-time PCR and levels of inflammatory cytokines IL-6, TNF-alpha, and IL-1 beta quantified by ELISA. Participants will undergo assessment of pain during the dental procedure to classify anesthetic success. Biological samples collected during treatment will be analyzed to compare gene and cytokine levels between groups. The main outcome measured is anesthetic success assessed 15 minutes after IANB administration during the procedure. Secondary outcomes include correlations between SCN9A expression and inflammatory markers. Statistical analyses will evaluate these relationships to identify potential biomarkers predicting anesthesia failure. The studys duration spans from recruitment to completion of data collection, ending in September 2026.

SCN9A Gene Expression and Inflammatory Cytokines