Achieving profound pulpal anesthesia in endodontics is a challenging task, particularly, in cases of acutely inflamed teeth. When conventional primary anesthetic techniques fail, there might be a need for a supplemental anesthesia. Local anesthetic(LA) administration may also add to patient’s discomfort. Cold application to a localized area to block the pain impulses is referred to as “Cryoanesthesia”, which is widely practiced in the field of medicine. One of the strategies to reduce pain perception during local anesthetic administration is precooling the injection site, as stated by Ghaderi et al.(2013) Further, use of cooled anesthetic solution to enhance pulpal anesthesia is attributed to an increase in affinity of the charged anesthetic molecule to nerve receptors. However, the effect of refrigerated 2% lignocaine HCl for maxillary infiltration anesthesia in molars has not been evaluated yet. Hence, the aim of the present study is to assess the effects of precooling the injection site and administration of cold 2% lignocaine HCl (8-10^oC) in symptomatic irreversible pulpitis of maxillary molars and also to compare the pain on injection, onset of action and anesthetic efficacy achieved with that of 2% lignocaine HCl (room temperature), with and without precooling the injection site. The experimental groups are:

Group 1: Precooling the injection site and cold 2% lignocaine HCl.

Group 2: LA gel with 2% lignocaine HCl (room temperature)

Pain score will be assessed using Heft Parker scale (VAS) and other parameters will be assessed using EPT.