The impact of finishing a root canal in one visit versus multiple visits for patients who need extra numbing for treating a painful lower back tooth with severe pulp damage.

INTERVENTION: Intervention1: Group 1 :Intra pulpal anesthesia and single visit endodontics: 6. Using a direct Halstedt technique, all patients will receive a primary IANB injection of 1.8ml of 2% lidocaine with 1: 80000 epinephrine. Aspiration will be done after reaching the target location and if found negative, solution will be deposited over 60 seconds. 7. Patients will be asked about the lip numbness after 110mins of injection and in those patient in which profound lip numbness will not be achieved, it will be considered as a case of missed block and patient shall be excluded from the study. Patients in which profound lip numbness will be achieved will be included in the study. 8. Rubber dam isolation will be done and after that endodontic access cavity preparation shall begun with endodontic access bur. If patient reports any pain during access cavity preparation, the operation shall stop there and then and patient will be asked to rate his/her pain score on VAS scale. If the score pointed by the lies in moderate/severe range, then patient shall be given intra pulpal supplementary anesthesia and will be allotted to one of the two experimental group i.e. single visit or multiple visit by means of sequentially numbered, sealed, opaque envelope. 9. After completion of the procedure, patients will be reminded telephonically to fill out the pain scores at 2, 6, 12, 24 and 36hours. 2. Intra pulpal anesthesia shall be given only once and single visit endodontic treatment shall be completed in maximum of 1‐1.5hrs Control Intervention1: Group 2: Intra pulpal anesthesia with multi visit endodontic treatment: 6. Using a direct Halstedt technique, all patients will receive a primary IANB injection of 1.8ml of 2% lidocaine with 1: 80000 epinephrine. Aspiration will be done after reaching CONDITION: Health Condition 1: K040‐ Pulpitis PRIMARY OUTCOME: 1.Intensity of postoperative pain at 2hrs,6hrs, 12hrs, 24hrs and 72hrs after the endodontic treatment in single visit and after first visit and final 2nd visit in multiple visit endodontic treatment ; 2.Success rate of root canal treatment as determined by clinical evaluation ( absence of subjective pain as described by the patient or objective pain as determine on percussion after 72 hours) after single visit or multiple visit RCT ; Timepoint: 1.Intensity of postoperative pain at 2hrs,6hrs, 12hrs, 24hrs and 72hrs after the endodontic treatment in single visit and after first visit and final 2nd visit in multiple visit endodontic treatment ; 2.Success rate of root canal treatment as determined by clinical evaluation ( absence of subjective pain as described by the patient or objective pain as determine on percussion after 72 hours) after single visit or multiple visit RCT ; SECONDARY OUTCOME: 1.Incidence of flare up/ swelling if any (to be examined at 24hrs & 48hrs after the completion of root canal treatment) ; 2.Treatment outcome according to tooth type, pre operative pain scores i.e. at 24hrs & 72hrs & 1 week from the completion of treatment. ; ; Timepoint: At 24hrs, 48hrs, 72hrs & 1 week from the completion of treatment. INCLUSION CRITERIA: 1.Patient reporting to OPD of Dentistry department with the diagnosis of symptomatic irreversible pulpitis in mandibular first or second molar. 2. Patient should not have taken any antibiotic/ analgesic at least 24hrs prior to dental visit.