title: Evaluation of the anesthetic effect of epinephrine-free articaine and mepivacaine through quantitative sensory testing.
abstract: BACKGROUND
  Long lasting anesthesia of the soft tissue beyond the dental treatment affects patients in daily routine. Therefore a sophisticated local anesthesia is needed. The purpose of this study was an evaluation of the clinical use of epinephrine-free local anesthetic solutions in routine short-time dental treatments.
  
  
  METHODS
  In a prospective, single-blind, non-randomized and controlled clinical trial, 31 patients (16 male, 15 female patients) undergoing short-time dental treatment under local anesthesia (plain solutions of articaine 4% and mepivacaine 3%) in area of maxillary canine were tested with quantitative sensory testing QST. Paired-Wilcoxon-testing (signed-rank-test) and Mc Nemar tests have been used for statistical results.
  
  
  RESULTS
  Significant differences in all tested parameters to the time of measurements were found. Mepivacaine showed a significantly stronger impact for the whole period of measurement (128 min) on thermal and mechanical test parameters and to the associated nerve fibers.
  
  
  CONCLUSIONS
  Plain articaine shows a faster onset of action associated with a shorter time of activity in comparison to plain mepivacaine. In addition to this articaine shows a significant low-graded effect on the tested nerve-fibers and therefore a least affected anesthesia to the patient. The clinical use of an epinephrine-free anesthetic solution can be stated as possible option in short dental routine treatments to the frequently used vasoconstrictor containing local anesthetics. Patients may benefit from shorter numbness.
authors.affiliation: Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Aachen University, Aachen, North Rhine-Westphalia, Germany. ssaidyekta@ukaachen.de.|Interdisciplinary Center for Clinical Research, RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany. ssaidyekta@ukaachen.de.
authors.forename: Sareh
authors.initials: S
authors.lastname: Said Yekta-Michael
authors.affiliation: Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Aachen University, Aachen, North Rhine-Westphalia, Germany. jstein@ukaachen.de.
authors.forename: Jamal M
authors.initials: JM
authors.lastname: Stein
authors.affiliation: Interdisciplinary Center for Clinical Research, RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany. ernstmarioth@yahoo.de.
authors.forename: Ernst
authors.initials: E
authors.lastname: Marioth-Wirtz
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002355:Carticaine / Q000008:administration & dosage*; D004837:Epinephrine; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage*; D009412:Nerve Fibers / Q000187:drug effects; D010147:Pain Measurement; D011446:Prospective Studies; D011984:Sensory Receptor Cells / Q000187:drug effects; D012684:Sensory Thresholds / Q000187:drug effects*; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D008619:Mepivacaine; D002355:Carticaine; D004837:Epinephrine