Anesthetic efficacy of articaine for combination labial plus lingual infiltrations versus labial infiltration in the mandibular lateral incisor.
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.
Nuzum
Frederick Micah
FM
Division of Endodontics, College of Dentistry, The Ohio State University, Columbus, Ohio 43210, USA.
Drum
Melissa
M
Nusstein
John
J
Reader
Al
A
Beck
Mike
M
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
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002355:Carticaine; D004837:Epinephrine