Abstract
Introduction
To assess the efficacy of buccal infiltrations of 4% articaine with 1:100,000 epinephrine
and 2% lidocaine with 1:80,000 epinephrine in achieving anesthesia in maxillary teeth
with irreversible pulpitis.
Methods
This randomized double-blind clinical trial included 100 patients diagnosed with irreversible
pulpitis in maxillary teeth. Patients received 2.0 mL 4% articaine with 1:100,000
epinephrine or 2% lidocaine with 1:80,000 epinephrine in the buccal sulcus adjacent
to the tooth with pulpitis. Before and every 2 minutes up to a maximum of 10 minutes
after injection, the response of the test tooth was assessed using an electronic pulp
tester. Successful pulp anesthesia was considered to have occurred when no response
was obtained to the maximum stimulation (80 reading) of the pulp tester during the
test period, at which time treatment commenced. Treatment was regarded as being successfully
completed when it was associated with no pain. The time to onset of successful pulp
anesthesia was recorded for each test tooth. Injection discomfort was recorded on
standard 100-mm visual analog scales (VASs). Data were analyzed by the Chi-square
and Student t tests.
Results
Fifty patients received articaine and 50 received lidocaine. Seventy-three of the
100 patients achieved pulpal anesthesia within 10 minutes of injection: 38 after articaine
and 35 after lidocaine (P = .5). The onset of pulpal anesthesia after articaine and lidocaine buccal infiltrations
was similar (mean and standard deviations: 4.9 ± 2.7 minutes vs 5.1 ± 2.4 minutes,
respectively; t = 0.2; P = .82). Pain-free treatment was completed in 33 patients after articaine and 29 after
lidocaine buccal infiltrations (P = .63). Although articaine buccal injection was significantly more comfortable than
lidocaine buccal injection (t = 2.3, P = .026), both were associated with mild discomfort on VAS (means ± standard deviation:
10.8 mm ± 11.7 mm vs 17.5 mm ± 17.6 mm, respectively).
Conclusions
There was no significant difference in efficacy between 4% articaine with 1:100,000
epinephrine and 2% lidocaine with 1:80,000 epinephrine in achieving anesthesia in
maxillary teeth with irreversible pulpitis after buccal infiltration.
Key Words
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Article info
Publication history
Published online: December 26, 2011
Footnotes
Dr Meechan acts as a consultant for Septodont.
Identification
Copyright
© 2012 Published by Elsevier Inc. All rights reserved.
