Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis.
The purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine to 2% lidocaine with 1:100,000 epinephrine for inferior alveolar nerve blocks in patients experiencing irreversible pulpitis in mandibular posterior teeth. Seventy-two emergency patients diagnosed with irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, 2.2 ml of 4% articaine with 1:100,000 epinephrine or 2.2 ml of 2% lidocaine with 1:100,000 epinephrine using a conventional inferior alveolar nerve block. Endodontic access was begun 15 min after solution deposition, and all patients were required to have profound lip numbness. Success was defined as none or mild pain (Visual Analogue Scale recordings) on endodontic access or initial instrumentation. The success rate for the inferior alveolar nerve block using articaine was 24% and for the lidocaine solution success was 23%. There was no significant difference (p = 0.89) between the articaine and lidocaine solutions. Neither solution resulted in an acceptable rate of anesthetic success in patients with irreversible pulpitis.
Department of Oral Surgery, Oral Pathology, and Anesthesiology, The Ohio State University, Columbus, OH 43218, USA.
Elizabeth
E
Claffey
Al
A
Reader
John
J
Nusstein
Mike
M
Beck
Joel
J
Weaver
D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002355:Carticaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008046:Lip / Q000187:drug effects; D008297:Male; D008340:Mandibular Nerve / Q000187:drug effects*; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D011671:Pulpitis / Q000503:physiopathology / Q000628:therapy*; D018915:Root Canal Preparation; D012390:Root Canal Therapy; D012677:Sensation / Q000187:drug effects; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D002355:Carticaine; D004837:Epinephrine