title: Comparative evaluation of the efficacy of 2% lidocaine containing 1:200,000 epinephrine with and without hyaluronidase (75 IU) in patients with irreversible pulpitis.
abstract: BACKGROUND
  The purpose of this study was to determine the anesthetic efficacy of lidocaine containing epinephrine compared with lidocaine containing epinephrine plus hyaluronidase (75 IU) when performing an inferior alveolar nerve block.
  
  
  METHODS
  Patients complaining of pain in the mandibular posterior teeth were selected. Based on their chief complaint, proper clinical and radiographic examinations were performed. Among them, 40 subjects diagnosed with irreversible pulpitis were selected. The inferior alveolar nerve block was induced using 3 mL 2% lidocaine with epinephrine. Hyaluronidase (75 IU) or a placebo was injected 30 minutes after the beginning of pulpal anesthesia (randomized and double-blind trial). The duration of the effect in the pulpal and gingival tissues was evaluated by the response to painful electrical stimuli applied to the adjacent premolar and by mechanical stimuli (pinprick) to the buccal gingiva, respectively.
  
  
  RESULTS
  In both pulpal and gingival tissues, the duration of the anesthetic effects with hyaluronidase was longer than with placebo.
  
  
  CONCLUSIONS
  Hyaluronidase increased the duration of the effects of lidocaine in inferior alveolar nerve blocks.
authors: Department of Conservative Dentistry and Endodontics, Navodaya Dental College and Hospital, Raichur, India.
authors: Sarvepalli Venkata
authors: SV
authors: Satish
authors: Krishna Prasad
authors: KP
authors: Shetty
authors: Krishnarao
authors: K
authors: Kilaru
authors: Puridi
authors: P
authors: Bhargavi
authors: E Srinivas
authors: ES
authors: Reddy
authors: Aditya
authors: A
authors: Bellutgi
mesh_terms: D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000951:Antigens, Neoplasm / Q000008:administration & dosage / Q000627:therapeutic use*; D003782:Dental Pulp / Q000187:drug effects; D004311:Double-Blind Method; D004558:Electric Stimulation; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D005881:Gingiva / Q000187:drug effects; D051548:Histone Acetyltransferases / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage / Q000627:therapeutic use*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008340:Mandibular Nerve / Q000187:drug effects; D009407:Nerve Block / Q000379:methods*; D017288:Pain Threshold / Q000187:drug effects; D010812:Physical Stimulation; D010919:Placebos; D011671:Pulpitis / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D000951:Antigens, Neoplasm; D010919:Placebos; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D051548:Histone Acetyltransferases; C115866:OGA protein, human; D006821:Hyaluronoglucosaminidase; D004837:Epinephrine
keywords: Hyaluronidase; inferior alveolar nerve block; irreversible pulpitis; pKa (acid dissociation constant)