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Effect of Topical Anesthesia on Pain during Infiltration Injection and Success of Anesthesia for Maxillary Central Incisors

Published:October 01, 2012DOI:https://doi.org/10.1016/j.joen.2012.08.011

      Abstract

      Introduction

      This study was performed to investigate the effect of topical anesthesia on pain during needle penetration and infiltration injection as well as the effect of pain during injection on success rate of anesthesia in maxillary central incisors.

      Methods

      In a crossover double-blind study, 25 volunteers randomly received either topical anesthesia or placebo before infiltration injection with prilocaine for their maxillary central incisors in 2 separate appointments. The pain after needle penetration and during injection was separately recorded. An electric pulp tester was used to evaluate the success of the anesthetic injection. Data were analyzed by McNemar, Wilcoxon, and χ2 tests.

      Results

      Overall for 50 injections, 72% of the teeth had successful anesthesia. No significant difference was found between placebo and topical anesthetic groups for the pain of needle penetration as well as pain during injection (P > .05). The volunteers who reported moderate-to-severe pain during injection showed no significant difference in the success rate of anesthesia compared with those with no or mild pain during injections (P > .05).

      Conclusions

      Use of topical anesthesia had no significant effect on pain during either needle penetration or injection. Pain during injection had no significant effect on the success of anesthesia.

      Key Words

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      References

        • Gill C.J.
        • Orr 2nd, D.L.
        A double-blind crossover comparison of topical anesthetics.
        J Am Dent Assoc. 1979; 98: 213-214
        • Hargreaves K.M.
        • Keiser K.
        Local anesthetic failure in endodontics: mechanisms and management (review).
        Endod Topics. 2002; 1: 26-39
        • Fukayama H.
        • Suzuki N.
        • Umino M.
        Comparison of topical anesthesia of 20% benzocaine and 60% lidocaine gel.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 94: 157-161
        • Drum M.
        • Reader A.
        • Beck M.
        Long buccal nerve block injection pain in patients with irreversible pulpitis.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 112: e51-e54
        • Kanaa M.D.
        • Meechan J.G.
        • Corbett I.P.
        • Whitworth J.M.
        Speed of injection influences efficacy of inferior alveolar nerve blocks: a double-blind randomized controlled trial in volunteers.
        J Endod. 2006; 32: 919-923
        • Bhalla J.
        • Meechan J.G.
        • Lawrence H.P.
        • et al.
        Effect of time on clinical efficacy of topical anesthesia.
        Anesth Prog. 2009; 56: 36-41
        • Parirokh M.
        • Satvati S.A.
        • Sharifi R.
        • et al.
        Efficacy of combining a buccal infiltration with an inferior alveolar nerve block for mandibular molars with irreversible pulpitis.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109: 468-473
        • Parirokh M.
        • Ashouri R.
        • Rekabi A.R.
        • et al.
        The efficacy of ibuprofen or indometacin on the success of inferior alveolar nerve block in teeth with irreversible pulpitis.
        J Endod. 2010; 36: 1450-1454
        • Aggarwal V.
        • Singla M.
        • Miglani S.
        • et al.
        A prospective, randomized, single-blind comparative evaluation of anesthetic efficacy of posterior superior alveolar nerve blocks, buccal infiltrations, and buccal plus palatal infiltrations in patients with irreversible pulpitis.
        J Endod. 2011; 37: 1491-1494
        • Kanaa M.D.
        • Whitworth J.M.
        • Meechan J.G.
        A comparison of the efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine in achieving pulpal anesthesia in maxillary teeth with irreversible pulpitis.
        J Endod. 2012; 38: 279-282
        • Sampaio R.M.
        • Carnaval T.G.
        • Lanfredi C.B.
        • et al.
        Comparison of the anesthetic efficacy between bupivacaine and lidocaine in patients with irreversible pulpitis of mandibular molar.
        J Endod. 2012; 38: 594-597
        • Hersh E.V.
        • Houpt M.I.
        • Cooper S.A.
        • et al.
        Analgesic efficacy and safety of an intraoral lidocaine.
        J Am Dent Assoc. 1996; 127: 1626-1634
        • Hutchins H.S.
        • Young F.A.
        • Lackland D.L.
        • Fishburne C.P.
        The effectiveness of topical anesthesia and vibration in alleviating the pain of oral injections.
        Anesth Prog. 1997; 44: 87-89
        • Nakanishi O.
        • Haas D.
        • Ishikawa T.
        • et al.
        Efficacy of mandibular topical anesthesia varies with the site of administration.
        Anesth Prog. 1996; 43: 14-19
        • Nusstein J.M.
        • Beck M.
        Effectiveness of 20% benzocaine as a topical anesthetic for intraoral injections.
        Anesth Prog. 2003; 50: 159-163
        • Rosa A.L.
        • Sverzut C.E.
        • Xavier S.P.
        • Lavrador M.A.
        Clinical effectiveness of lidocaine and benzocaine for topical anesthesia.
        Anesth Prog. 1999; 46: 97-99
        • Rosivack R.G.
        • Koenigsberg S.R.
        • Maxwell K.C.
        An analysis of the effectiveness of two topical anaesthetics.
        Anesth Prog. 1990; 37: 290-292
        • Ianiro S.R.
        • Jeansonne B.G.
        • McNeal S.F.
        • Eleazer P.D.
        The effect of preoperative acetaminophen or a combination of acetaminophen and ibuprofen on the success of inferior alveolar nerve block for teeth with irreversible pulpitis.
        J Endod. 2007; 33: 11-14
        • Aggarwal V.
        • Singla M.
        • Kabi K.
        Comparative evaluation of effect of preoperative oral medication of ibuprofen and ketorolac on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis: a prospective, double-blind, randomized clinical trial.
        J Endod. 2010; 36: 375-378
        • Mikesell P.
        • Nusstein J.
        • Reader A.
        • et al.
        A comparison of articaine and lidocaine for inferior alveolar nerve blocks.
        J Endod. 2005; 31: 265-270
        • Kreimer T.
        • Kiser 2nd, R.
        • Reader A.
        • et al.
        Anesthetic efficacy of combinations of 0.5 mol/L mannitol and lidocaine with epinephrine for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis.
        J Endod. 2012; 38: 598-603
        • Tortamano I.P.
        • Siviero M.
        • Costa C.G.
        • et al.
        A comparison of the anesthetic efficacy of articaine and lidocaine in patients with irreversible pulpitis.
        J Endod. 2009; 35: 165-168
        • Pfeil L.
        • Drum M.
        • Reader A.
        • et al.
        Anesthetic efficacy of 1.8 milliliters and 3.6 milliliters of 2% lidocaine with 1:100,000 epinephrine for posterior superior alveolar nerve blocks.
        J Endod. 2010; 36: 598-601
        • Martin M.
        • Nusstein J.
        • Drum M.
        • et al.
        Anesthetic efficacy of 1.8 mL versus 3.6 mL of 4% articaine with 1:100,000 epinephrine as a primary buccal infiltration of the mandibular first molar.
        J Endod. 2011; 37: 588-592
        • Reisman D.
        • Reader A.
        • Nist R.
        • et al.
        Anesthetic efficacy of the supplemental intraosseous injection of 3% mepivacaine in irreversible pulpitis.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 84: 676-682
        • Beneito-Broton R.
        • Peñarrocha-Oltra D.
        • Ata-Ali J.
        • Peñarrocha M.
        • et al.
        Intraosseous anesthesia with solution injection controlled by a computerized system versus conventional oral anesthesia: a preliminary study.
        Med Oral Patol Oral Cir Bucal. 2012; 17: e426-429
        • Batista da Silva C.
        • Berto L.A.
        • Volpato M.C.
        • et al.
        Anesthetic efficacy of articaine and lidocaine for incisive/mental nerve block.
        J Endod. 2010; 36: 438-441
        • Wahl M.J.
        • Schmitt M.M.
        • Overton D.A.
        • Gordon M.K.
        Injection pain of bupivacaine with epinephrine vs prilocaine plain.
        J Am Dent Assoc. 2002; 133: 1652-1656
        • Wahl M.J.
        • Schmitt M.M.
        • Overton D.A.
        Injection pain of prilocaine plain, mepivacaine plain, articaine with epinephrine, and lidocaine with epinephrine.
        Gen Dent. 2006; 54: 168-171
        • Jung I.Y.
        • Kim J.H.
        • Kim E.S.
        • et al.
        An evaluation of buccal infiltrations and inferior alveolar nerve blocks in pulpal anesthesia for mandibular first molars.
        J Endod. 2008; 34: 11-13
        • Meechan J.G.
        Intraoral topical anesthesia.
        Periodontology. 2000; 2008: 56-79
        • Franz-Montan M.
        • de Paula E.
        • Groppo F.C.
        • et al.
        Liposome-encapsulated ropivacaine for intraoral topical anesthesia.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110: 800-804
        • Reader A.W.
        • Nusstein J.M.
        • Hargreaves K.M.
        Local anesthesia in endodontics.
        in: Hargreaves K.M. Cohen S. Pathways of the Pulp. 10th ed. Mosby Elsevier, St Louis, MO2011: 691-719
        • Lee S.
        • Reader A.
        • Nusstein J.
        • et al.
        Anesthetic efficacy of the anterior middle superior alveolar (AMSA) injection.
        Anesth Prog. 2004; 51: 80-89
        • Meyer T.N.
        • Lemos L.L.
        • Nascimento C.N.
        • Lellis W.R.
        Effectiveness of nasopalatine nerve block for anesthesia of maxillary central incisors after failure of the anterior superior alveolar nerve block technique.
        Braz Dent J. 2007; 18: 69-73
        • Berberich G.
        • Reader A.
        • Drum M.
        • et al.
        A prospective, randomized, double-blind comparison of the anesthetic efficacy of two percent lidocaine with 1:100,000 and 1:50,000 epinephrine and three percent mepivacaine in the intraoral, infraorbital nerve block.
        J Endod. 2009; 35: 1498-1504
        • Karkut B.
        • Reader A.
        • Drum M.
        • et al.
        A comparison of the local anesthetic efficacy of the extraoral versus the intraoral infraorbital nerve block.
        J Am Dent Assoc. 2010; 141: 185-192
        • Corbett I.P.
        • Jaber A.A.
        • Whitworth J.M.
        • Meechan J.G.
        A comparison of the anterior middle superior alveolar nerve block and infraorbital nerve block for anesthesia of maxillary anterior teeth.
        J Am Dent Assoc. 2010; 141: 185-192
        • Lawaty I.
        • Drum M.
        • Reader A.
        • Nusstein J.
        A prospective, randomized, double-blind comparison of 2% mepivacaine with 1:20,000 levonordefrin versus 2% lidocaine with 1:100,000 epinephrine for maxillary infiltrations.
        Anesth Prog. 2010; 57: 139-144