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Anesthetic Comparisons of 4% Concentrations of Articaine, Lidocaine, and Prilocaine as Primary Buccal Infiltrations of the Mandibular First Molar: A Prospective Randomized, Double-blind Study.
MedLine Citation:
PMID:  25218523     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Studies have shown the superiority of 4% articaine with 1:100,000 epinephrine over 2% lidocaine with 1:100,000 epinephrine when used as a primary buccal infiltration of the mandibular first molar. A study using other 4% anesthetic formulations may help determine the role of concentration in the increased efficacy of 4% articaine. The authors conducted a prospective randomized, double-blind, crossover study comparing the pulpal anesthesia obtained with 4% concentrations of articaine, lidocaine, and prilocaine formulations as primary buccal infiltrations of the mandibular first molar.
METHODS: Sixty asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of 1.8 mL 4% articaine with 1:100,000 epinephrine, 4% lidocaine with 1:100,000 epinephrine, and 4% prilocaine with 1:200,000 epinephrine in 3 separate appointments. An electric pulp tester was used to test the first molar for anesthesia in 3-minute cycles for 60 minutes after the infiltrations. Successful anesthesia was defined as 2 consecutive 80/80 readings.
RESULTS: The success rate for the 4% articaine formulation was 55%, 33% for the 4% lidocaine formulation, and 32% for the 4% prilocaine formulation. There was a significant difference between articaine and both lidocaine (P = .0071) and prilocaine (P = .0187) formulations.
CONCLUSIONS: A 4% articaine formulation was statistically better than both 4% lidocaine and 4% prilocaine formulations for buccal infiltration of the mandibular first molar in asymptomatic mandibular first molars. However, the success rate of 55% is not high enough to support its use as a primary buccal infiltration technique in the mandibular first molar.
Authors:
Brett Nydegger; John Nusstein; Al Reader; Melissa Drum; Mike Beck
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-10
Journal Detail:
Title:  Journal of endodontics     Volume:  -     ISSN:  1878-3554     ISO Abbreviation:  J Endod     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7511484     Medline TA:  J Endod     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
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