title: Clinical efficacy of lidocaine, mepivacaine, and articaine for local infiltration.
abstract: OBJECTIVE
  To assess and compare the efficacy of single buccal and palatal infiltration of lidocaine, mepivacaine, or articaine with 1:100 000 epinephrine by maxillary anesthetic injection.
  
  
  METHODS
  A double-blinded, randomized, clinical trial was conducted with 33 patients undergoing upper premolar extraction. The patients were randomly allocated into one of three groups, according to the local anesthetic agent used: 2% lidocaine, 2% mepivacaine, or 4% articaine, all with 1:100 000 epinephrine, and were blinded to the anesthetic used. The extent of anesthetization, pulpal anesthetization in adjacent teeth, pain on injection, and adverse effects of the anesthetic agents were assessed.
  
  
  RESULTS
  The extent of anesthetization produced by 4% articaine (42 mm) was statistically more significant (P ≤ 0.05) than 2% lidocaine (33 mm) and 2% mepivacaine (32.5 mm). The successful anesthetization of adjacent teeth occurred more often in the articaine group than in the lidocaine and mepivacine groups, although not to a statistically-significant extent. The pain scores for the injections were comparable between the three groups.
  
  
  CONCLUSIONS
  Local anesthetization using 4% articaine with 1:100 000 epinephrine covers a wider area of soft tissue and adjacent teeth than 2% lidocaine or 2% mepivacaine with 1:100 000 epinephrine, which is sufficient for the extraction of one or two teeth.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand.
authors.forename: Suttapreyasri
authors.initials: S
authors.lastname: Srisurang
authors.forename: Leepong
authors.initials: L
authors.lastname: Narit
authors.forename: Pripatnanont
authors.initials: P
authors.lastname: Prisana
mesh_terms: D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D001641:Bicuspid / Q000601:surgery; D002355:Carticaine / Q000008:administration & dosage* / Q000009:adverse effects; D003782:Dental Pulp / Q000187:drug effects; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage; D005881:Gingiva / Q000187:drug effects; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008437:Maxilla / Q000187:drug effects; D008619:Mepivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D010146:Pain / Q000209:etiology; D010147:Pain Measurement / Q000379:methods; D013997:Time Factors; D014081:Tooth Extraction / Q000379:methods; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D008619:Mepivacaine; D002355:Carticaine; D004837:Epinephrine
keywords: articaine; efficacy; lidocaine; local anesthetic; mepivacaine