title: Endodontic anesthesia in mandibular molars: a clinical study.
abstract: Sixty-one mandibular molar teeth with clinically manifest pulpitis, which required endodontic therapy, were studied. Twenty-seven subjects received standard inferior alveolar nerve block (IANB) with 2% lidocaine HCI with 1:100,000 epinephrine and 34 subjects received IANB with 3% mepivacaine with no vasoconstrictor. Pulpal anesthesia was assessed with dichlorodifluormethane (DDM). Subjects who gave a positive response to DDM were given a periodontal ligament injection with 2% lidocaine with 1:100,000 epinephrine. This study showed that 3% mepivacaine HCI is as effective as 2% lidocaine HCI in achieving pulpal anesthesia in mandibular molars with IANB. Of a total 61 IANB with lip anesthesia, 23 subjects required periodontal ligament injection to achieve a negative response to DDM. It was concluded that lip anesthesia is not a reliable indicator of pulpal anesthesia. The use of DDM is a reliable method of determining true pulpal anesthesia.
authors.affiliation: Department of Restorative Dentistry and Endodontology, University of Connecticut Health Center, School of Dental Medicine, Farmington.
authors.forename: H P
authors.initials: HP
authors.lastname: Cohen
authors.forename: B Y
authors.initials: BY
authors.lastname: Cha
authors.forename: L S
authors.initials: LS
authors.lastname: Spångberg
mesh_terms: D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods; D016009:Chi-Square Distribution; D005617:Chlorofluorocarbons, Methane; D003791:Dental Pulp Test / Q000379:methods*; D004341:Drug Evaluation; D006801:Humans; D008012:Lidocaine; D008334:Mandible; D008619:Mepivacaine; D008963:Molar; D010147:Pain Measurement; D011671:Pulpitis / Q000601:surgery
chemical_list: D005617:Chlorofluorocarbons, Methane; C049237:dichlorofluoromethane; D008012:Lidocaine; D008619:Mepivacaine