Paresthesia in dentistry: The ignored neurotoxicity of local anesthetics

Tan, Ying; Shi, Rong-jia; Ke, Bowen; Tang, Yaling; Liang, Xin‐hua

doi:10.1016/j.heliyon.2023.e18031

Cited by 4 publications

(2 citation statements)

References 138 publications

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“…The exact mechanism underlying paresthesia following Articaine administration remains unclear [44]. However, the literature reveals that the most probable cause for this reaction is a higher concentration of Articaine (4%) compared to conventionally used 2% Lidocaine [44][45][46]. This theory is supported by the work of Cornelius et al, when they injected 4% Articaine into the sciatic nerves of rats, it led to a loss of sensory signals in 90% of them, but with 2% Articaine, this loss was observed in only 10% of the rats [47].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy of Lidocaine and Articaine as Inferior Alveolar Nerve Blocking Agents in Patients with Symptomatic Irreversible Pulpitis: Randomized Controlled Trial

Hassan,

Ahmed,

Saqib

et al. 2023

Medicina

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Background and Objectives: Lidocaine Hydrochloride has been the standard choice for local anesthesia in dentistry and Articaine’s unique structure and growing popularity make it a viable alternative. Due to contradictory results in prior research and a scarcity of trials conducted in the Pakistani population, this study aims to compare the anesthetic efficacy of Lidocaine with Articaine for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis. Materials and Methods: This double-blinded, randomized controlled trial included 152 patients who were selected by consecutive non-probability sampling. The participants included patients who presented with symptomatic irreversible pulpitis in mandibular posterior teeth (molars and premolars) and depicted normal apical tissue radiographically. The patients were equally and randomly divided into two groups. The control group received 2% Lidocaine Hydrochloride injections, and the experiment group received 4% Articaine Hydrochloride injections. Participants scored their pain on the HP-VAS both before and after the administration of anesthesia. A value of 54 mm or less on the scale indicated effective anesthesia. The data obtained were analyzed using SPSS. Chi-square test was applied to analyze data for statistical significance. Results: There was no statistically significant difference in the efficacy of the two anesthetic agents. During access cavity preparation, Lidocaine demonstrated a success rate of 93%, whereas Articaine exhibited a slightly higher success rate of 97%. During initial instrumentation, the success rates for Lidocaine and Articaine were 72% and 71%, respectively. This suggests that both Lidocaine and Articaine were effective in achieving anesthesia during the dental procedure in patients with symptomatic irreversible pulpitis, with Articaine showing a slightly better success rate, although the difference was not statistically significant. Conclusions: The anesthetic efficacy of Articaine is similar to that of lidocaine in subjects with symptomatic irreversible pulpitis. Hence, Articaine can serve as an alternative to Lidocaine for local anesthesia administration in dentistry.

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Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy of Lidocaine and Articaine as Inferior Alveolar Nerve Blocking Agents in Patients with Symptomatic Irreversible Pulpitis: Randomized Controlled Trial

Hassan,

Ahmed,

Saqib

et al. 2023

Medicina

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“…Parestesia é caracterizada por uma alteração de sensibilidade de uma região específica, devido, à um dano gerado ao nervo sensitivo responsável pela inervação da área em questão. O paciente poderá relatar sensibilidade alterada a dor, ao calor e frio, sensação de formigamento, coceira e/ou dormência conforme Veloso, Dourado, Santos e Lima (2017) em conjunto com Tan et al (2023).…”

Section: Introductionunclassified

Parestesia associada ao tratamento endodôntico

Bento,

Ferrante,

Passos

2023

RSD

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O presente trabalho teve por objetivo uma revisão bibliográfica acerca dos aspectos relacionados à parestesia ao longo do tratamento endodontico, discutindo sobre os sinais clínicos apresentados, etiologia, diagnósticos e possíveis tratamentos. Para a formulação do trabalho, foram selecionados 23 artigos, que se encontravam publicados em sua íntegra, no período de 2007 a 2022 nos idiomas português e inglês. A parestesia associada ao tratamento endodôntico ocorre em decorrência da sobreinstrumentação, sobreobturação, infecções periapicais, extravasamento de soluções irrigadoras e ao longo da anestesia. Os principais sinais e sintomas apresentados são dores intensas, sensação de queimação, coceira e alteração de sensibilidade em relação ao frio ou calor. Conforme os estudos encontrados, concluiu-se que, em decorrência da baixa incidência, as informações sobre o assunto ainda se encontram escassas, não existindo um protocolo de tratamento definido em históricos de parestesia envolvendo a Endodontia. Entretanto, sabe-se que, a história clínica do paciente, a evolução dos sintomas, anamnese detalhada, testes de neurossensibilidade e exames por imagem, facilitam o diagnóstico e auxiliam para um tratamento de sucesso. Entende-se que é necessário abranger os estudos nesta área, onde a prevenção, se associa a um planejamento adequado do procedimento, utilização correta dos materiais, conhecimento do limite apical e anatômico.

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