title: Anesthetic efficacy of articaine for combination labial plus lingual infiltrations versus labial infiltration in the mandibular lateral incisor.
abstract: BACKGROUND
  Previous studies have shown higher success rates when using an articaine formulation versus a lidocaine formulation for buccal mandibular first molar infiltrations. However, there is little information on articaine's effect in mandibular anterior teeth.
  
  
  METHODS
  The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 2 sets of mandibular lateral incisor infiltrations given in 2 separate appointments in 82 adult subjects. One set of infiltrations consisted of an initial labial infiltration of a cartridge of 4% articaine with 1:100,000 epinephrine plus a lingual infiltration of the same anesthetic and dose. The other set of infiltrations consisted of an initial labial infiltration of a cartridge of 4% articaine with 1:100,000 epinephrine plus a mock lingual infiltration. The authors used an electric pulp tester to test the lateral incisor for pulpal anesthesia in 2-minute cycles for 60 minutes after the injections.
  
  
  CONCLUSIONS
  The labial plus lingual infiltration significantly improved the success rate (no response to 2 consecutive 80 readings with the pulp tester) to 98% when compared with a labial infiltration of a cartridge of the same articaine formulation (76% success). The combination labial and lingual infiltrations did not provide pulpal anesthesia for an hour.
authors.affiliation: Division of Endodontics, College of Dentistry, The Ohio State University, Columbus, Ohio 43210, USA.
authors.forename: Frederick Micah
authors.initials: FM
authors.lastname: Nuzum
authors.forename: Melissa
authors.initials: M
authors.lastname: Drum
authors.forename: John
authors.initials: J
authors.lastname: Nusstein
authors.forename: Al
authors.initials: A
authors.lastname: Reader
authors.forename: Mike
authors.initials: M
authors.lastname: Beck
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002355:Carticaine / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003782:Dental Pulp / Q000187:drug effects; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000187:drug effects*; D007267:Injections; D008297:Male; D008334:Mandible / Q000187:drug effects*; D008875:Middle Aged; D009339:Needles; D010147:Pain Measurement; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002355:Carticaine; D004837:Epinephrine