title: A prospective, randomized, double-blind comparison of bupivacaine and lidocaine for maxillary infiltrations.
abstract: The purpose of this prospective, randomized, double-blind study was to evaluate the anesthetic efficacy of 1.8 mL 0.5% bupivacaine with 1:200,000 epinephrine and 1.8 mL of 2% lidocaine with 1:100,000 epinephrine in maxillary lateral incisors and first molars. Sixty-five subjects randomly received, in a double-blind manner, two infiltrations at two separate appointments, in a crossover design. The injections consisted of maxillary lateral incisor and first molar infiltrations of 1.8 mL 0.5% bupivacaine with 1:200,000 epinephrine and 1.8 mL 2% lidocaine with 1:100,000 epinephrine. In maxillary lateral incisors, bupivacaine exhibited a significantly lower anesthetic success rate (obtaining two consecutive 80 readings with the pulp tester within 10 minutes) of 78% when compared with a 97% success rate with lidocaine. In maxillary first molars, bupivacaine's onset of pulpal anesthesia (7.7 minutes) was significantly slower than lidocaine (4.3 minutes). Bupivacaine had a lower success rate than lidocaine (64% versus 82%) but there was no significant difference between the two solutions. Neither solution provided pulpal anesthesia for 1 hour.
authors.affiliation: Section of Endodontics, College of Dentistry, Ohio State University, 305 West 12th Avenue, Columbus, OH 43210, USA.
authors.forename: Renie
authors.initials: R
authors.lastname: Gross
authors.forename: Melissa
authors.initials: M
authors.lastname: McCartney
authors.forename: Al
authors.initials: A
authors.lastname: Reader
authors.forename: Mike
authors.initials: M
authors.lastname: Beck
mesh_terms: D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000627:therapeutic use*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007180:Incisor / Q000187:drug effects; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008963:Molar / Q000187:drug effects; D013997:Time Factors
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D002045:Bupivacaine