Effect of Local and Application of Amitriptyline and Imipramine on Teeth with Irreversible Pulpitis Failed Pulpal Anesthesia: A Randomized, Double-blind, Controlled Trial

Introduction: To evaluate the analgesic effect of amitriptyline and imipramine after local application on the dentine of “hot teeth” with failed pulpal anesthesia. Materials and Methods: This study was a randomized, double-blind clinical trial that was performed on 33 consenting adult patients who were referred to us and had mandibular molars diagnosed with symptomatic irreversible pulpitis and experienced pain during access cavity preparation after receiving successful inferior alveolar nerve block with lidocaine. Either amitriptyline, imipramine or placebo was administered locally on the exposed dentine of the teeth. Pre and post-application pain levels were evaluated by McGill visual analog scale. Results: Amitriptyline significantly reduced the pain experienced by patients (P = 0.032). Imipramine also reduced the experienced pain but the pain relief was not statistically significant when compared with the placebo. Conclusion: Local administration of amitriptyline on exposed dentine can reduce the pain experienced by patients with a “hot tooth.