title: Anesthetic efficacy of the intraosseous injection of 2% lidocaine (1:100,000 epinephrine) and 3% mepivacaine in mandibular first molars.
abstract: OBJECTIVE
  This study compared the anesthetic efficacy of a primary intraosseous injection of 2% lidocaine with 1:100,000 epinephrine and 3% mepivacaine in human mandibular first molars. Injection pain and healing postoperatively were also assessed for the intraosseous injection.
  
  
  METHODS
  With the use of a repeated-measures design, 42 subjects randomly received intraosseous injections of 1.8 ml of 2% lidocaine with 1:100,000 epinephrine or 1.8 ml of 3% mepivacaine in a double-blind manner at two successive appointments. The first molar and adjacent teeth were blindly tested with an electric pulp tester at 2-minute cycles for 60 minutes. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading) for two consecutive readings.
  
  
  RESULTS
  Anesthetic success occurred in 74% of the first molars with 2% lidocaine with 1:100,000 epinephrine and in 45% with 3% mepivacaine. The difference was statistically significant (p < 0.05). Overall, onset was rapid for the intraosseous injections, the duration of pulpal anesthesia steadily declined over the 60 minutes, the majority of the subjects had no pain or mild pain with perforation and solution deposition, and 5% of the subjects had delayed healing at the perforation sites.
  
  
  CONCLUSIONS
  The results of this study indicate that the primary intraosseous injection of 2% lidocaine with 1:100,000 epinephrine is more successful and results in a longer duration of pulpal anesthesia as compared with 3% mepivacaine in noninflamed mandibular first molars. Most subjects reported no or mild pain during perforation and injection.
authors.affiliation: Ohio State University, Columbus, USA.
authors.forename: K
authors.initials: K
authors.lastname: Replogle
authors.forename: A
authors.initials: A
authors.lastname: Reader
authors.forename: R
authors.initials: R
authors.lastname: Nist
authors.forename: M
authors.initials: M
authors.lastname: Beck
authors.forename: J
authors.initials: J
authors.lastname: Weaver
authors.forename: W J
authors.initials: WJ
authors.lastname: Meyers
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003791:Dental Pulp Test; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008334:Mandible; D008619:Mepivacaine / Q000008:administration & dosage*; D008963:Molar; D010147:Pain Measurement; D018709:Statistics, Nonparametric; D014081:Tooth Extraction
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D008619:Mepivacaine