This study tests three different ways to numb the pain in patients whose first pain relief shot didn t work during molar treatments. The goal is to find the best method to make the procedure pain-free.

INTERVENTION: Intervention1: Inferior Alveolar Nerve Block with 2 percent Lidocaine: Patient is first given IANB with 2 percent Lidocaine and the supplemental anesthesia with 4 percent Articaine using Buccal Infiltration, Intraligamentary Injection and Intrapulpal Injection Control Intervention1: Buccal Infiltration, Intraligamentary Injection and Intrapulpal Injection: Patients fulfilling the inclusion criteria will be given a supplemental anesthetic after a failed inferior alveolar nerve block. This part of the study is a three arm, parallel group, double blind, randomised clinical trial. The three groups assigned are: Group A (Buccal infiltration): This group comprises of 20 subjects in which a supplemental Buccal infiltration will be given after a failed Inferior Alveolar Nerve Block Group B (Intraligamentary Injection): This group comprises of 20 subjects in which a supplemental Intraligamentary Injection will be given after a failed Inferior Alveolar Nerve Block Group C (Intrapulpal Injection): This group comprises of 20 subjects in which a supplemental Intrapulpal Injection will be given after a failed Inferior Alveolar Nerve Block. The supplemental injection will be given 15 minutes after the IANB CONDITION: Health Condition 1: K040‐ Pulpitis PRIMARY OUTCOME: Pain assessment will be conducted following the administration of a supplemental anesthetic injection after a failed inferior alveolar nerve block, during access opening, initial file placement and instrument the tooth using a 10‐point pain intensity scale post‐treatment.Timepoint: The Supplemental Injection will be given 15 minutes after the IANB. SECONDARY OUTCOME: NATimepoint: NA INCLUSION CRITERIA: 1. Patient experiencing spontaneous and moderate to severe pain in mandibular 1st Molar diagnosed with symptomatic irreversible pulpitis 2. Patients in the age group of 18‐60 years 3. Mature teeth with closed ape X 4. Teeth with healthy periodontium