title: Bupivacaine 0.5% versus articaine 4% for the removal of lower third molars. A crossover randomized controlled trial.
abstract: OBJECTIVE
  To compare the anesthetic action of 0.5% bupivacaine in relation to 4% articaine, both with 1:200,000 epinephrine, in the surgical removal of lower third molars. As a secondary objective hemodynamic changes using both anesthetics were analyzed.
  
  
  METHODS
  Triple-blind crossover randomized clinical trial. Eighteen patients underwent bilateral removal of impacted lower third molars using 0.5% bupivacaine or 4% articaine in two different appointments. Preoperative, intraoperative and postoperative variables were recorded. Differences were assessed with McNemar tests and repeated measures ANOVA tests.
  
  
  RESULTS
  Both solutions exhibited similar latency times and intraoperative efficacy. Statistical significant lower pain levels were observed with bupivacaine between the fifth (p=0.011) and the ninth (p=0.007) postoperative hours. Bupivacaine provided significantly longer lasting soft tissue anesthesia (p<0.5). Systolic blood pressure and heart rate values were significantly higher with articaine.
  
  
  CONCLUSIONS
  Bupivacaine could be a valid alternative to articaine especially due to its early postoperative pain prevention ability.
authors.affiliation: School of Dentistry, University of Barcelona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Sancho-Puchades
authors.forename: Miguel-Ángel
authors.initials: MÁ
authors.lastname: Vílchez-Pérez
authors.forename: Eduard
authors.initials: E
authors.lastname: Valmaseda-Castellón
authors.forename: Jordi
authors.initials: J
authors.lastname: Paredes-García
authors.forename: Leonardo
authors.initials: L
authors.lastname: Berini-Aytés
authors.forename: Cosme
authors.initials: C
authors.lastname: Gay-Escoda
mesh_terms: D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D002355:Carticaine / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D014081:Tooth Extraction; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D002355:Carticaine; D002045:Bupivacaine