title: Comparison of the anesthetic efficacy between bupivacaine and lidocaine in patients with irreversible pulpitis of mandibular molar.
abstract: BACKGROUND
  The purpose of this study was to compare the anesthetic efficacy of 0.5% bupivacaine with 1:200,000 epinephrine with that of 2% lidocaine with 1:100,000 epinephrine during pulpectomy in patients with irreversible pulpitis in mandibular posterior teeth.
  
  
  METHODS
  Seventy volunteers, patients with irreversible pulpitis admitted to the Emergency Center of the School of Dentistry at the University of São Paulo, randomly received a conventional inferior alveolar nerve block containing 3.6 mL of either 0.5% bupivacaine with 1:200,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine. During the subsequent pulpectomy, we recorded the patients' subjective assessments of lip anesthesia, the absence/presence of pulpal anesthesia through electric pulp stimulation, and the absence/presence of pain through a verbal analog scale.
  
  
  RESULTS
  All patients reported lip anesthesia after the application of either inferior alveolar nerve block. By measuring pulpal anesthesia success with the pulp tester, lidocaine had a higher success rate (42.9%) than bupivacaine (20%). For patients reporting none or mild pain during pulpectomy, the success rate of bupivacaine was 80% and lidocaine was 62.9%. There were only statistically significant differences to the success of pulpal anesthesia.
  
  
  CONCLUSIONS
  Neither of the solutions resulted in an effective pain control during irreversible pulpitis treatments of mandibular molars.
authors.affiliation: Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Roberta Moura
authors.initials: RM
authors.lastname: Sampaio
authors.forename: Talita Girio
authors.initials: TG
authors.lastname: Carnaval
authors.forename: Camila Bernardeli
authors.initials: CB
authors.lastname: Lanfredi
authors.forename: Anna Carolina Ratto Tempestini
authors.initials: AC
authors.lastname: Horliana
authors.forename: Rodney Garcia
authors.initials: RG
authors.lastname: Rocha
authors.forename: Isabel Peixoto
authors.initials: IP
authors.lastname: Tortamano
mesh_terms: D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D003782:Dental Pulp / Q000503:physiopathology; D003791:Dental Pulp Test / Q000379:methods; D004311:Double-Blind Method; D004558:Electric Stimulation / Q000379:methods; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008046:Lip / Q000294:innervation; D008297:Male; D008334:Mandible / Q000473:pathology; D008340:Mandibular Nerve / Q000187:drug effects; D008875:Middle Aged; D008963:Molar / Q000187:drug effects* / Q000473:pathology; D009407:Nerve Block / Q000379:methods; D010147:Pain Measurement; D011446:Prospective Studies; D011670:Pulpectomy / Q000379:methods; D011671:Pulpitis / Q000628:therapy*; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D002045:Bupivacaine; D004837:Epinephrine