An evaluation of an electric pulp tester as a measure of analgesia in human vital teeth

Dreven, Lee J.; Reader, Al; Beck, F. Michael; Meyers, William J.; Weaver, Joël M.

doi:10.1016/s0099-2399(87)80097-3

Cited by 164 publications

(112 citation statements)

References 13 publications

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“…Among these, there was 1 patient in the articaine group (4.54%), 5 in the lidocaine group (22.7%) and 1 in the mepivacaine group (4.54%) in which pulpal anesthesia was confirmed with the pulp tester (as determined by a negative response to the maximum stimulus of 80 μA). These results are consistent with studies by Dreven et al (13) and other authors (5,6) showing that in teeth with irreversible pulpitis, negative responses to the maximum stimulation of 80 μA with an electric pulp stimulator does not clinically guarantee pulp anesthesia and thus analgesia. In contrast, pulpal anesthesia was not confirmed (as determined by a positive response to a stimulus below 80 μA), in 1, 3 and 2 patients in the articaine, lidocaine and mepivacaine groups, respectively, although these patients did not report pain during the pulpectomy.…”

Section: Discussionsupporting

confidence: 92%

Anesthetic Efficacy in Irreversible Pulpitis: A Randomized Clinical Trial

et al. 2016

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Inferior alveolar nerve block has a high failure rate in the treatment of mandibular posterior teeth with irreversible pulpitis. The aim of this study was to compare the anesthetic efficacy of 4% articaine, 2% lidocaine and 2% mepivacaine, all in combination with 1:100,000 epinephrine, in patients with irreversible pulpitis of permanent mandibular molars during a pulpectomy procedure. Sixty-six volunteers from the Emergency Center of the School of Dentistry, University of São Paulo, randomly received 3.6 mL of local anesthetic as a conventional inferior alveolar nerve block (IANB). The subjective signal of lip numbness, pulpal anesthesia and absence of pain during the pulpectomy procedure were evaluated respectively, by questioning the patient, stimulation using an electric pulp tester and a verbal analogue scale. All patients reported the subjective signal of lip numbness. Regarding pulpal anesthesia success as measured with the pulp tester, the success rate was respectively 68.2% for mepivacaine, 63.6% for articaine and 63.6% for lidocaine. Regarding patients who reported no pain or mild pain during the pulpectomy, the success rate was, respectively 72.7% for mepivacaine, 63.6% for articaine and 54.5% for lidocaine. These differences were not statistically significant. Neither of the solutions resulted in 100% anesthetic success in patients with irreversible pulpitis of mandibular molars.

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Section: Discussionsupporting

confidence: 92%

Anesthetic Efficacy in Irreversible Pulpitis: A Randomized Clinical Trial

et al. 2016

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“…We based our use of the pulp test reading of 80ösig-naling maximum outputöas a criterion for pulpal anesthesia on the studies of Dreven and colleagues 23 and Certosimo and Archer. 24 These studies 23,24 showed that no patient response to an 80 reading ensured pulpal anesthesia in vital asymptomatic teeth.…”

Section: Discussionmentioning

confidence: 99%

“…24 These studies 23,24 showed that no patient response to an 80 reading ensured pulpal anesthesia in vital asymptomatic teeth. Additionally, Certosimo and Archer 24 showed that electric pulp test readings less than 80 resulted in pain during operative procedures in asymptomatic teeth.…”

Section: Discussionmentioning

confidence: 99%

A Prospective, Randomized, Double-Blind Study of the Anesthetic Efficacy of Sodium Bicarbonate Buffered 2% Lidocaine With 1 : 100,000 Epinephrine in Inferior Alveolar Nerve Blocks

Whitcomb¹,

Drum

Reader

et al. 2010

Anesthesia Progress

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The authors, using a crossover design, randomly administered, in a double-blind manner, inferior alveolar nerve ( IAN ) blocks using a buffered 2% lidocaine with 1 : 100,000 epinephrine/sodium bicarbonate formulation and an unbuffered 2% lidocaine with 1 : 100,000 epinephrine formulation at 2 separate appointments spaced at least 1 week apart. An electric pulp tester was used in 4-minute cycles for 60 minutes to test for anesthesia of the first and second molars, premolars, and lateral and central incisors. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 15 minutes, and the 80 reading was continuously sustained for 60 minutes. For the buffered 2% lidocaine with 1 : 100,000 epinephrine/sodium bicarbonate formulation, successful pulpal anesthesia ranged from 10^71%. For the unbuffered 2% lidocaine with 1 : 100,000 epinephrine formulation, successful pulpal anesthesia ranged from 10^72%. No significant differences between the 2 anesthetic formulations were noted. The buffered lidocaine formulation did not statistically result in faster onset of pulpal anesthesia or less pain during injection than did the unbuffered lidocaine formulation. We concluded that buffering a 2% lidocaine with 1 : 100,000 epinephrine with sodium bicarbonate, as was formulated in the current study, did not statistically increase anesthetic success, provide faster onset, or result in less pain of injection when compared with unbuffered 2% lidocaine with 1 : 100,000 epinephrine for an IAN block.

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“…[9][10][11][12] A number of studies have used no response to maximal electronic pulp tester output (80 reading) as a measure of pulpal anaesthesia. [13][14][15][16][17][18][19][20] Pulp anaesthesia can be defined in many ways, and with varying degrees of stringency.…”

Section: Discussionmentioning

confidence: 99%