Anesthetic efficacy of articaine for combination labial plus lingual infiltrations versus labial infiltration in the mandibular lateral incisor

J Endod. 2010 Jun;36(6):952-6. doi: 10.1016/j.joen.2010.03.004. Epub 2010 Apr 14.

Abstract

Introduction: Previous studies have shown higher success rates when using an articaine formulation versus a lidocaine formulation for buccal mandibular first molar infiltrations. However, there is little information on articaine's effect in mandibular anterior teeth.

Methods: The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 2 sets of mandibular lateral incisor infiltrations given in 2 separate appointments in 82 adult subjects. One set of infiltrations consisted of an initial labial infiltration of a cartridge of 4% articaine with 1:100,000 epinephrine plus a lingual infiltration of the same anesthetic and dose. The other set of infiltrations consisted of an initial labial infiltration of a cartridge of 4% articaine with 1:100,000 epinephrine plus a mock lingual infiltration. The authors used an electric pulp tester to test the lateral incisor for pulpal anesthesia in 2-minute cycles for 60 minutes after the injections.

Results and conclusions: The labial plus lingual infiltration significantly improved the success rate (no response to 2 consecutive 80 readings with the pulp tester) to 98% when compared with a labial infiltration of a cartridge of the same articaine formulation (76% success). The combination labial and lingual infiltrations did not provide pulpal anesthesia for an hour.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anesthesia, Dental / methods*
  • Anesthesia, Local / methods*
  • Anesthetics, Local / administration & dosage*
  • Carticaine / administration & dosage*
  • Cross-Over Studies
  • Dental Pulp / drug effects
  • Epinephrine / administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Incisor / drug effects*
  • Injections
  • Male
  • Mandible / drug effects*
  • Middle Aged
  • Needles
  • Pain Measurement
  • Prospective Studies
  • Single-Blind Method
  • Time Factors
  • Vasoconstrictor Agents / administration & dosage
  • Young Adult

Substances

  • Anesthetics, Local
  • Vasoconstrictor Agents
  • Carticaine
  • Epinephrine