Comparison of 4% articaine and 0.5% bupivacaine anesthetic efficacy in orthodontic extractions: Prospective, randomized crossover study

Thakare, Ashwin; Bhate, Kalyani

doi:10.1016/j.aat.2014.04.006

Cited by 34 publications

(29 citation statements)

References 20 publications

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“…However, no statistically significant differences in anesthetic efficacy were recorded between the two solutions. [ 21 22 ] In addition, Ashraf et al . [ 23 ] conducted a double-blind randomized trial on 125 patients to compare the anesthetic success rate of BI injections of articaine and lidocaine when supplemented with an IANB using either 2% lidocaine or 4% articaine.…”

Section: Discussionmentioning

confidence: 99%

Comparison of speed of action and injection discomfort of 4% articaine and 2% mepivacaine for pulpal anesthesia in mandibular teeth: A randomized, double-blind cross-over trial

Gazal

2015

Eur J Dent

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Objective:To compare the injection pain and speed of local anesthetic effect induced by tissue infiltration of mepivacaine 2% with epinephrine 1:100,000 versus articaine 4% with epinephrine 1:100,000 in securing mandibular first molar pulp anesthesia.Materials and Methods:Totally, 25 patients were recruited in a crossover, randomized, double-blind study. Each subject received injections of mepivacaine 2% with epinephrine 1:100,000 as inferior alveolar nerve block (IANB) supplemented with either articaine 4% with epinephrine 1:100,000 (septocaine) or mepivacaine 2% buccal infiltration (BI) injection on two visits. The time of first numbness to associated lip, tongue and tooth was recorded by asking the participant directly and using electrical pulp tester. Anesthetic success was considered when two consecutive maximal stimulation on pulp testing readings without sensation. The patients rated the pain of infiltration using a 100 mm visual analog scale immediately after receiving each injection. The pain scores were compared using the paired t-test.Results:There were significant differences in the meantime of first numbness to associated lip and tooth of volunteers between mepivacaine and articaine BI groups P = 0.03 and 0.002. Volunteers in articaine group recorded earlier lip and teeth numbness than those in mepivacaine group. There were significant differences between the mean pain scores for volunteers in the post IANB and postbuccal injection groups (t-test: P <0.001). Mepivacaine IANB injection was significantly more painful than articaine/mepivacaine buccal injection.Conclusions:About 4% articaine was faster than 2% mepivacaine (both with 1:100,000 adrenaline) in anesthetizing the pulps of lower molar teeth after BIs. Earlier lip and teeth numbness were recorded in articaine group. Articaine and mepivacaine BIs were more comfortable than mepivacaine IANB injections.

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Section: Discussionmentioning

confidence: 99%

Comparison of speed of action and injection discomfort of 4% articaine and 2% mepivacaine for pulpal anesthesia in mandibular teeth: A randomized, double-blind cross-over trial

Gazal

2015

Eur J Dent

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“…Minimally effective concentration of adrenaline added to bupivacaine is 1 mg/ml. Addition of adrenaline with bupivacaine hydrochloride produces pain relieving effect, decreases the absorption of local anesthetic agent which prolongs the duration of action thereby decreases blood concentration of drug and its toxicity and adverse drug reaction [33,34].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study Between Bupivacaine with Adrenaline and Carbonated Bupivacaine with Adrenaline for Surgical Removal of Impacted Mandibular Third Molar

Shyamala¹,

Ramesh²,

Yuvaraj³

et al. 2015

J. Maxillofac. Oral Surg.

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Objectives To compare the effectiveness of bupivacaine with adrenaline with that of carbonated bupivacaine with adrenaline on pain, onset of anesthesia and duration of anesthesia following surgical removal of impacted mandibular third molar. Study design All the patients who underwent surgical removal of impacted mandibular third molar and who fulfilled our inclusion and exclusion criteria from 1st June 2013 to 30th June 2014 were included in our study. Patients who were diagnosed as having impacted mandibular third molar were randomly allocated to two groups namely group A (bupivacaine with adrenaline), group B (carbonated bupivacaine with adrenaline). Pain during deposition of local anesthetic, onset of anesthesia and duration of anesthesia were compared between the two groups. The collected data were subjected to statistical analysis by Chi Square test, Mann-Whitney U test. Results and conclusion The efficacy of carbonated bupivacaine with adrenaline is more compared with bupivacaine with adrenaline in decreasing pain on deposition of local anesthetic solution and in rapid onset of anesthesia. The duration of anesthesia for carbonated bupivacaine with adrenaline and bupivacaine with adrenaline had no significant difference. The use of carbonated bupivacaine with adrenaline will reduce the patient discomfort both intraoperatively and post-operatively.

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“… pulpal anaesthesia in the anterior mandible compared with inferior dental block (IDBs) . is suitable for exodontia in adults and children is ideal for implant surgery is suitable for periodontal surgery improved patient comfort. Patients will undoubtedly prefer having full lingual sensation and shorter duration LA anaesthesia after dental treatment …”

Section: Part B: Local Anaesthetic‐related Nerve Injuries – a Modern mentioning

confidence: 99%

“…There has been a resurgence in interest in infiltration anaesthesia in the mandible as a consequence of the introduction of 4% articaine. Recent studies have suggested that infiltration of 4% articaine in the mandibular molar region can obtain anaesthesia of the lower first molar that is as effective as an inferior dental block. Thus, it is ironic that 4% articaine, the drug that has caused such controversy concerning nerve damage, may be helpful in preventing this complication.…”

Section: Should Our La Practice Change?mentioning

confidence: 99%

Trigeminal nerve injuries

Renton

2018

Aust Endodontic J

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Trigeminal nerve injury is the most problematic consequence of dental surgical procedures with major medico-legal implications. In trigeminal nerve injuries related to dentistry, 70% are reported to have chronic neuropathic post-traumatic pain. Neuropathic pain states require different therapeutic approaches such as anticonvulsants, which are not effective in nociceptive pain. Major causes of nerve injuries in the orofacial region are endodontics and administration of local anaesthetics. Endodontic treatment of premolar and mandibular teeth has the potential to damage the inferior alveolar nerve via direct trauma, pressure or neurotoxicity. Persistent pain after endodontics has been reported to occur in 3-13% of patients, whilst surgical endodontics resulted in chronic neuropathic pain in 5% of patients. Most sensory nerve injuries related to dentistry are permanent; only local anaesthetic nerve injuries have a 75% likelihood of recovery. Nerve injury from local anaesthetics shows an incidence of 1 in 14 000 with 25% permanent injury from general dental restorative procedures and 1 in 3300 with 29% permanence from oral surgery.

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Comparison of 4% articaine and 0.5% bupivacaine anesthetic efficacy in orthodontic extractions: Prospective, randomized crossover study

Abstract: Articaine seemed to have better potency and efficacy in terms of onset of action and lower pain scores compared to the bupivacaine group. Further studies are required to confirm these results.

Cited by 34 publications

References 20 publications

Comparison of speed of action and injection discomfort of 4% articaine and 2% mepivacaine for pulpal anesthesia in mandibular teeth: A randomized, double-blind cross-over trial

Comparison of speed of action and injection discomfort of 4% articaine and 2% mepivacaine for pulpal anesthesia in mandibular teeth: A randomized, double-blind cross-over trial

A Comparative Study Between Bupivacaine with Adrenaline and Carbonated Bupivacaine with Adrenaline for Surgical Removal of Impacted Mandibular Third Molar

Trigeminal nerve injuries

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