الفهرس 
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Abstract
The present study was designed to investigate the efficacy of intrapulpal injection of fentanyl as a supplementary technique in management of patients with acute irreversible pulpitis during endodontic treatment through comparative study with intrapulpal injection of mepivacaine and saline.
This study was conducted on 60 aCfulthealthy patients presented with acute symptomatic irreversible pulpitis oflower first molar tooth due to caries,
multiple restorations or trauma.
Diagnosis was based on the history and clinical examination, which made by use of provoking stimuli (application of cold and percussion),
The diagnosis was confirmed by cold thermal test using ethyl chloride spray on a cotton swab which was applied directly on the affected tooth.
The selected patients, were randomly divided into 3 equal groups”:
- group I (Saline group):
This group was composed of 20 patients received supplementary intrapulpal ”
injection of 0.1 m1 saline solution after receiving the lANB.
- group II (Fentanyl group):
This group was composed of 20 patients received supplementary intrapulpal injection of 0.1 m1 Fentanyl after receiving the IANB.
- group III (Mepivacaine group):
This group was composed of 20 patients received supplementary intrapulpa1 injection of 0.1 m1 Mepivacaine with adrenaline of 1:200,000 after receiving the lANB.
Patients rated their pain intensity before administration of anesthesia on a five point scale. Also, the dentist assessed pain intensity through observation of
the reactions of the patients during the procedure on the same five point scale
(0-4) where 0 = no pam tolerated.