A prospective, randomized, double-blind comparison of the anesthetic efficacy of two percent lidocaine with 1:100,000 epinephrine and three percent mepivacaine in the maxillary high tuberosity second division 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 and 3% mepivacaine in the maxillary high tuberosity second division nerve block.


METHODS
Fifty subjects randomly received maxillary high tuberosity second division nerve blocks by using 3.6 mL of 2% lidocaine with 1:100,000 epinephrine and 3.6 mL of 3% mepivacaine at 2 separate appointments spaced at least 1 week apart. The anterior, premolar, and molar teeth were pulp tested in 4-minute cycles for a total of 60 minutes. Success was defined as no subject response to 2 consecutive 80 readings with the electric pulp tester.


CONCLUSIONS
The high tuberosity approach to the maxillary second division nerve block with both anesthetic formulations resulted in a high success rate (92%-98%) for the first and second molars. Approximately 76%-78% of the second premolars were anesthetized with both anesthetic formulations. Both anesthetic formulations were ineffective for the anterior teeth and first premolars. The use of 3% mepivacaine provided a significantly shorter duration of pulpal anesthesia than 2% lidocaine with 1:100,000 epinephrine in the molars and premolars.
Amy
A
Forloine
Melissa
M
Drum
Al
A
Reader
John
J
Nusstein
Mike
M
Beck
D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001641:Bicuspid / Q000294:innervation; D018592:Cross-Over Studies; D003481:Cuspid / Q000294:innervation; D003782:Dental Pulp / Q000294:innervation; D003791:Dental Pulp Test; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007180:Incisor / Q000294:innervation; D007267:Injections / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008442:Maxillary Nerve / Q000187:drug effects*; D008619:Mepivacaine / Q000008:administration & dosage*; D008875:Middle Aged; D008963:Molar / Q000294:innervation; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*; D055815:Young Adult
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D008619:Mepivacaine; D004837:Epinephrine