title: Anesthetic efficacy of 1.8 mL versus 3.6 mL of 4% articaine with 1:100,000 epinephrine as a primary buccal infiltration of the mandibular first molar.
abstract: BACKGROUND
  No study has compared 1.8 mL and 3.6 mL 4% articaine with 1:100,000 epinephrine in a mandibular buccal infiltration of the first molar. The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 1.8 mL and 3.6 mL 4% articaine with 1:100,000 epinephrine as a primary infiltration in the mandibular first molar.
  
  
  METHODS
  Eighty-six asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of 1.8 mL or 3.6 mL 4% articaine with 1:100,000 epinephrine in two separate appointments. The authors used an electric pulp tester to test the first molar for anesthesia in 3-minute cycles for 90 minutes after the injections.
  
  
  RESULTS
  Compared with the 1.8-mL volume of 4% articaine with 1:100,000 epinephrine, the 3.6-mL volume showed a statistically higher success rate (70% vs 50%).
  
  
  CONCLUSIONS
  The anesthetic efficacy of 3.6 mL 4% articaine with 1:100,000 epinephrine is better than 1.8 mL of the same anesthetic solution in a primary mandibular buccal infiltration of the first molar. However, the success rate of 70% is not high enough to support its use as a primary injection technique in the mandibular first molar.
authors.forename: Matthew
authors.initials: M
authors.lastname: Martin
authors.forename: John
authors.initials: J
authors.lastname: Nusstein
authors.forename: Melissa
authors.initials: M
authors.lastname: Drum
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 / Q000706:statistics & numerical data*; D000772:Anesthesia, Local / Q000706:statistics & numerical data*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002355:Carticaine / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003782:Dental Pulp / Q000187:drug effects*; D003791:Dental Pulp Test; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008297:Male; D008334:Mandible; D008875:Middle Aged; D008963:Molar / Q000187:drug effects*; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002355:Carticaine; D004837:Epinephrine