A prospective, randomized, double-blind comparison of the anesthetic efficacy of two percent lidocaine with 1:100,000 and 1:50,000 epinephrine and three percent mepivacaine in the intraoral, infraorbital nerve block.
BACKGROUND
The purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of 2% lidocaine with 1:100,000 epinephrine, 2% lidocaine with 1:50,000 epinephrine, and 3% mepivacaine in the intraoral, infraorbital nerve block.


METHODS
Forty subjects randomly received intraoral, infraorbital nerve blocks by using a cartridge of 2% lidocaine with 1:100,000 or 1:50,000 epinephrine and a cartridge of 3% mepivacaine at 3 separate appointments spaced at least 1 week apart. The anteriors, premolars, and first molar were pulp tested in 4-minute cycles for a total of 60 minutes.


CONCLUSIONS
The intraoral, infraorbital nerve block was ineffective in providing profound pulpal anesthesia of the maxillary central incisor, lateral incisor, and first molar. Successful pulpal anesthesia of the canine and first and second premolars ranged from 75%-92% by using 2% lidocaine with 1:100,000 and 1:50,000 epinephrine. However, pulpal anesthesia did not last for 60 minutes. The use of 3% mepivacaine provided a shorter duration of anesthesia than the lidocaine formulations with epinephrine in the canines and premolars.
Berberich
Gerhard
G
Division of Endodontics, College of Dentistry, The Ohio State University, Columbus, Ohio 43210, USA.
Reader
Al
A
Drum
Melissa
M
Nusstein
John
J
Beck
Mike
M
D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001641:Bicuspid / Q000294:innervation; D003481:Cuspid / Q000294:innervation; D003782:Dental Pulp / Q000294:innervation; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007180:Incisor / Q000294:innervation; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008437:Maxilla / Q000294:innervation; D008619:Mepivacaine / Q000008:administration & dosage*; D008963:Molar / Q000294:innervation; D009407:Nerve Block / Q000379:methods*; D009915:Orbit / Q000294:innervation*; D011446:Prospective Studies; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*; D055815:Young Adult
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D008619:Mepivacaine; D004837:Epinephrine