title: A prospective, randomized, double-blind comparison of 2% lidocaine with 1:100,000 and 1:50,000 epinephrine and 3% mepivacaine for maxillary infiltrations.
abstract: BACKGROUND
  The purpose of this prospective, randomized, double-blind crossover study was to evaluate the anesthetic efficacy of 2% lidocaine with 1:100,000 and 1:50,000 epinephrine and 3% mepivacaine in maxillary lateral incisors and first molars.
  
  
  METHODS
  Sixty subjects randomly received, in a double-blind manner, maxillary lateral incisor and first molar infiltrations of 1.8 mL of 2% lidocaine with 1:100,000 epinephrine, 2% lidocaine with 1:50,000 epinephrine, and 3% mepivacaine at three separate appointments spaced at least 1 week apart. The teeth were pulp tested in 3-minute cycles for a total of 60 minutes.
  
  
  CONCLUSIONS
  Anesthetic success and the onset of pulpal anesthesia were not significantly different between 2% lidocaine with either 1:100,000 or 1:50,000 epinephrine and 3% mepivacaine for the lateral incisor and first molar. Increasing the epinephrine concentration from 1:100,000 to 1:50,000 in a 2% lidocaine formulation significantly decreased pulpal anesthesia of short duration for the lateral incisor but not the first molar. For both the lateral incisor and first molar, 3% mepivacaine significantly increased pulpal anesthesia of short duration compared with 2% lidocaine with either 1:100,000 or 1:50,000 epinephrine.
authors.affiliation: Private Practice, State College, PA, USA.
authors.forename: Rick
authors.initials: R
authors.lastname: Mason
authors.forename: Melissa
authors.initials: M
authors.lastname: Drum
authors.forename: Al
authors.initials: A
authors.lastname: Reader
authors.forename: John
authors.initials: J
authors.lastname: Nusstein
authors.forename: Mike
authors.initials: M
authors.lastname: Beck
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003791:Dental Pulp Test; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007180:Incisor; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008437:Maxilla; D008619:Mepivacaine / Q000008:administration & dosage*; D008963:Molar; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D008619:Mepivacaine; D004837:Epinephrine