Assessment of Different Medications in Modifying the Efficacy of Anesthesia in Mandibular Molars With Acute Irreversible Pulpitis

Inclusion Criteria: * • From 18 to 65 years old. * Both male and female participants were accepted. * Mandibular molars diagnosed with acute irreversible pulpitis. * Class I occlusion with normal occlusal contacts Exclusion Criteria: * • Individuals with significant health issues: a history of gastrointestinal disorders, active bronchial asthma, renal diseases, liver dysfunction, heart diseases, blood disorders, hypertension or poorly controlled diabetes mellitus. * Immunocompromised patients. * Sensitivity or allergy to any of the pharmaceuticals or medications intended for use in the study * Participants who could not read, comprehend, or complete the baseline pain scale questionnaire. * Cases where clinical examination suggested necrotic teeth leading to a false positive diagnosis. * Teeth exhibiting periodontal disease or periapical lesions confirmed through clinical assessment and pre-operative radiographs. * Sensitivity to percussion or palpation in the included teeth