title: Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in intraosseous injections in symptomatic irreversible pulpitis of mandibular molars: anesthetic efficacy and cardiovascular effects.
abstract: OBJECTIVE
  The aim of this study was to compare the cardiovascular effects and the anesthetic efficacy of intraosseous injections of 4% articaine with 1:100,000 epinephrine (EPI100) or 4% articaine with 1:200,000 epinephrine (EPI200).
  
  
  METHODS
  In this prospective, randomized, double-blind study, 0.9 mL EPI100 and EPI200 solutions were administered for endodontic treatment of mandibular molars with symptomatic irreversible pulpitis in 60 patients. The anesthetic success and pain during anesthesia were evaluated by visual analog scale. The cardiovascular parameters evaluated were heart rate, diastolic/systolic blood pressure, pulse oximetry, and electrocardiogram changes.
  
  
  RESULTS
  Both solutions provided high anesthetic efficacy (96.8% and 93.1% for EPI100 and EPI200, respectively; P > .05), and the cardiovascular parameters showed minimal incidences of significant differences throughout the clinical procedure.
  
  
  CONCLUSIONS
  The epinephrine concentration did not affect the efficacy of 4% articaine, and both solutions produced a high success level of pulpal anesthesia. Intraosseous delivery by slow speed of injection did not induce significant clinical changes in cardiovascular parameters.
authors: Department of Pharmacology, Anesthesiology, and Therapeutics, São Leopoldo Mandic Dental School, Campinas, Brazil. leandroapp@sedcare.com.br
authors: Leandro Augusto Pinto
authors: LA
authors: Pereira
authors: Francisco Carlos
authors: FC
authors: Groppo
authors: Cristiane de Cássia
authors: Cde C
authors: Bergamaschi
authors: John Gerard
authors: JG
authors: Meechan
authors: Juliana Cama
authors: JC
authors: Ramacciato
authors: Rogério Heládio Lopes
authors: RH
authors: Motta
authors: José
authors: J
authors: Ranali
mesh_terms: D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002355:Carticaine / Q000008:administration & dosage*; D003782:Dental Pulp / Q000187:drug effects; D004311:Double-Blind Method; D004562:Electrocardiography / Q000187:drug effects; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007267:Injections / Q000295:instrumentation; D008297:Male; D008334:Mandible; D008875:Middle Aged; D008963:Molar / Q000473:pathology*; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement; D011446:Prospective Studies; D011671:Pulpitis / Q000628:therapy*; D012390:Root Canal Therapy / Q000379:methods*; 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; D010100:Oxygen; D004837:Epinephrine