Effects of Two Different Anesthetic Solutions on Injection Pain, Efficacy, and Duration of Soft-Tissue Anesthesia with Inferior Alveolar Nerve Block for Primary Molars.
OBJECTIVE
The purpose of the study was to compare the efficacy, injection pain, duration of soft tissue anesthesia, and postoperative complications of two different anesthetics (2% lidocaine with 1:80,000 epinephrine and 3% plain mepivacaine) in pediatric patients in inferior alveolar nerve block (IANB) administered by a computer-controlled delivery system (CCDS).


METHODS
The study was conducted as a randomized, controlled-crossover, double-blind clinical trial with 60 children requiring bilateral pulpotomy or extraction of primary mandibular molars. A CCDS was used to deliver 3% mepivacaine to 1 primary tooth and 2% lidocaine to the contralateral tooth with an IANB technique. Severity of pain and efficacy of anesthesia were evaluated using the Face, Legs, Activity, Cry, Consolability Scale, and comfort and side effects were assessed using a questionnaire. Data were analyzed using the Mann-Whitney U, Wilcoxon t, and Fisher exact tests.


RESULTS
Patients receiving 2% lidocaine experienced significantly less pain during injection than those receiving 3% mepivacaine, and no significant differences were found in the pain scores during treatments or in postoperative complications between the two anesthetics. The mean durations of anesthesia for 3% mepivacaine and 2% lidocaine were 139.68 minutes and 149.10 minutes, respectively.


CONCLUSIONS
Plain mepivacaine and 2% lidocaine were similarly effective in pulpotomy and the extraction of primary mandibular molars. Although the use of 3% mepivacaine provided a shorter duration of anesthesia than 2% lidocaine, both solutions showed similar results in terms of postoperative complications.
Ülkü Şermet
ÜŞ
Elbay
Mesut
M
Elbay
Emine
E
Kaya
Sinem
S
Yıldırım
D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002648:Child; D002652:Child Behavior; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects / Q000295:instrumentation; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008340:Mandibular Nerve / Q000187:drug effects*; D008619:Mepivacaine / Q000008:administration & dosage; D008963:Molar / Q000294:innervation*; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D011183:Postoperative Complications; D011446:Prospective Studies; D011672:Pulpotomy / Q000379:methods; D013997:Time Factors; D014081:Tooth Extraction / Q000379:methods; D014094:Tooth, Deciduous / Q000294:innervation*; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D008619:Mepivacaine; D004837:Epinephrine
injections; pain; primary teeth