title: Clinical use of an epinephrine-reduced (1/400,000) articaine solution in short-time dental routine treatments--a multicenter study.
abstract: The addition of epinephrine in dental local anaesthesia results in a longer and deeper anaesthesia under almost ischemic conditions. For short-time dental treatments, epinephrine-reduced anaesthetics may offer shorter and more individual anaesthesia with reduced potential side effects. The aim of this study was a clinical evaluation of anaesthetic potency and adverse effects of an epinephrine-reduced articaine formulation in dental patients undergoing short-time routine treatment. In a prospective clinical, not interventional, study between January 2008 and February 2009, 908 patients undergoing short-time dental treatment in five medical centers were anaesthetized with 4% articaine 1:400,000 epinephrine (Ubistesin, 3M/ESPE, Seefeld, Germany). Efficacy and safety in clinical use were evaluated. A follow-up after 1 day was conducted by telephone survey. A mean amount of 1.3-ml anaesthetic solution was needed to achieve a complete or sufficient anaesthesia in 97% (n = 876) of cases. A second injection had to be done in 3.7% (n = 34) before and in 11.9% (n = 108) during treatment. Here, the second injection had to be applied after a mean of 48.6 min. The mean duration of soft tissue anaesthesia after infiltration was 146.6 min, after nerve block 187.7 min. The painful treatment took a mean of 50.2 min and the total treatment time summed up to 68.8 min. In 1.7% cases (n = 15), unwanted side effects were observed. The results indicate that a lower concentration of epinephrine in combination with the 4% articaine solution leads to a high success rate of efficacy. The clinical use of a 4% articaine 1:400,000 epinephrine solution can be stated as safe and effective in short dental routine treatments. Reconsiderations concerning limitations of indication or additional contraindications are not necessary.
authors.affiliation: Policlinic for Oral Surgery, University Medical Centre of the Johannes Gutenberg University Mainz, Augustusplatz 2, 55131 Mainz, Germany. daublaen@uni-mainz.de
authors.forename: Monika
authors.initials: M
authors.lastname: Daubländer
authors.forename: Peer W
authors.initials: PW
authors.lastname: Kämmerer
authors.forename: Brita
authors.initials: B
authors.lastname: Willershausen
authors.forename: Michael
authors.initials: M
authors.lastname: Leckel
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Lauer
authors.forename: Siegmar
authors.initials: S
authors.lastname: Buff
authors.forename: Benita
authors.initials: B
authors.lastname: Rösl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002355:Carticaine / Q000008:administration & dosage* / Q000009:adverse effects; D002908:Chronic Disease; D003729:Dental Care / Q000145:classification; D017266:Dental Prosthesis; D003793:Dental Restoration, Permanent; D004837:Epinephrine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods; D019647:Oral Surgical Procedures; D010147:Pain Measurement; D010510:Periodontal Diseases / Q000601:surgery; D011446:Prospective Studies; D012390:Root Canal Therapy; D012449:Safety; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002355:Carticaine; D004837:Epinephrine