Buffered articaine infiltration for primary maxillary molar extractions: a randomized controlled study

Dhake, Parag; Nagpal, Devendra; Chaudhari, Purva; Lamba, Gagandeep; Hotwani, Kavita; Singh, Prabhat Kumar

doi:10.17245/jdapm.2022.22.5.387

Cited by 3 publications

(8 citation statements)

References 10 publications

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Section: Discussionmentioning

confidence: 95%

“…In a study by Dhake et al 17 buffered articaine showed significantly lower pain scores, a faster onset, and less pain during the procedure for both subjective and objective evaluation. 17…”

Section: Discussionmentioning

confidence: 95%

“…In a study by Dhake et al 17 buffered articaine showed significantly lower pain scores, a faster onset, and less pain during the procedure for both subjective and objective evaluation. 17 According to the results of our study, the highest pain scores at all 3-time points were observed in a group that received nonbuffered 2% lidocaine with epinephrine. On the contrary, the lowest scores were present in a group that received a buffered solution of 2% lidocaine with sodium bicarbonate in a 3:1 ratio.…”

Section: Discussionmentioning

confidence: 95%

“…15 In a meta-analysis by Tong et al 16 , a significant reduction of postoperative pain was reported following an articaine injection. In a study by Dhake et al 17 buffered articaine showed significantly lower pain scores, a faster onset, and less pain during the procedure for both subjective and objective evaluation. 17 According to the results of our study, the highest pain scores at all 3-time points were observed in a group that received nonbuffered 2% lidocaine with epinephrine.…”

Section: Discussionmentioning

confidence: 95%

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Buffered Versus Nonbuffered Local Anesthetics and Local Pain Scores in Upper Eyelid Blepharoplasty: Randomized Controlled Trial

Vasović

Karamarković

Stojičić

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: This split-face study aimed to see whether different types of local anesthetics or their buffered/nonbuffered combinations produce lower pain scores in upper eyelid blepharoplasty.Methods: The study involved 288 patients, randomly divided into 9 groups: 1) 2% lidocaine with epinephrine-Lid + Epi; 2) 2% lidocaine with epinephrine and 0.5% bupivacaine (1:1)-Lid + Epi + Bupi; 3) 2% lidocaine with 0.5% bupivacaine (1:1)-Lid + Bupi; 4) 0.5% bupivacaine-Bupi; 5) 2% lidocaine-Lid; 6) 4% articaine hydrochloride with epinephrine-Art + Epi; 7) buffered 2% lidocaine/epinephrine with sodium bicarbonate (SB) in a 3:1 ratio-Lid + Epi + SB; 8) buffered 2% lidocaine with SB in a 3:1 ratio-Lid + SB; 9) buffered 4% articaine hydrochloride/epinephrine with SB in a 3:1 ratio-Art + Epi + SB. Following the injection of the first eyelid and a 5-minute period of soft pressure on the injection site, patients were asked to rate their pain level on the Wong-Baker Face Pain Rating Visual Analogue Scale. Rating of the pain level was repeated 15 and 30 minutes following anesthetic administration.Results: The lowest pain scores at the first time point were observed in Lid + SB when compared with all of the other groups (p < 0.05). At the final time point, significantly lower scores were also observed in Lid + SB, Lid + Epi + SB, and Art + Epi + SB when compared with the Lid + Epi group (p < 0.05).Conclusion: These findings could help surgeons select an appropriate combination of local anesthetics, particularly in patients with lower pain threshold and tolerance because buffered combinations of local anesthetics produce significantly lower pain scores compared with nonbuffered solutions.

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Section: Discussionmentioning

confidence: 95%

“…In a study by Dhake et al 17 buffered articaine showed significantly lower pain scores, a faster onset, and less pain during the procedure for both subjective and objective evaluation. 17…”

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

See 2 more Smart Citations

Buffered Versus Nonbuffered Local Anesthetics and Local Pain Scores in Upper Eyelid Blepharoplasty: Randomized Controlled Trial

Vasović

Karamarković

Stojičić

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Further improvement of the diffusion properties of articaine solutions may lead to useful applications in infiltration anesthesia of mandibular molars as an alternative to IANB. Previous studies on the effect of buffering on the clinical efficacy of articaine have demonstrated controversial results [ 6 10 11 ].…”

Section: Introductionmentioning

confidence: 99%

Anesthetic efficacy of buffered 4% articaine for mandibular first molar infiltration: a crossover clinical trial

Manta,

Dabarakis,

Lillis

et al. 2023

J Dent Anesth Pain Med

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Background The limited studies on the effect of buffering on the clinical efficacy of articaine have reported controversial results. The purpose of this study was to clinically compare the pain of injection, anesthetic success, onset, and duration of pulpal anesthesia of buffered 4% articaine with epinephrine 1:100000 versus a non-buffered 4% articaine with epinephrine 1:100000 formulation for buccal infiltration of the mandibular first molar. Methods Sixty-three volunteers were enrolled in the study. All volunteers received two injections consisting of a single mandibular first molar buccal infiltration with 1.8 ml of 4% articaine with epinephrine 1:100000 and 1.8 ml of 4% articaine with epinephrine 1:100000 buffered with 8.4% sodium bicarbonate. The infiltrations were applied in two separate appointments spaced at least one week apart. After injection of the anesthetic solution at the examined site, the first molar was pulp-tested every 2 min for the next 60 min. Results Successful pulpal anesthesia was recorded in 69.8% of cases using non-buffered articaine solution and 76.2% of cases using buffered articaine solution, with no significant difference between the formulations (P = 0.219). The mean time of anesthesia onset for the volunteers with successful anesthetic outcome in both formulations (n = 43) was 6.6 ± 1.6 min for the non-buffered articaine solution and 4.5 ± 1.6 min for the buffered solution, which differed significantly (P = 0.001). In the same volunteers, the mean duration of pulpal anesthesia was 28.4 ± 7.1 min for non-buffered articaine solution and 30.2 ± 8.5 min for buffered articaine solution, with no significant difference between the formulations (P = 0.231). Considering the pain of injection, regardless of the anesthetic success, the mean values of VAS were 11.3 ± 8.2 mm for the non-buffered articaine solution and 7.8 ±6.5 mm for the buffered articaine solution, which differed significantly (P = 0.001 < 0.05). Conclusion According to the present study, 4% articaine with epinephrine can benefit from buffering and provide better anesthetic behavior, with improved onset and less pain during injection.

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Buffered versus Non-buffered Local Anaesthesia in Minor Oral Surgery - A Comparative Study

Gorrela,

Srujana,

Arthi

2024

Annals of Maxillofacial Surgery

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Introduction: Commercially available local anaesthetics are acidic solutions associated with the vasopressor sting on injection, relatively slower onset of action and pain during palatal injections. The above drawbacks can be addressed by anaesthetic buffering. This prospective study was aimed at comparing the efficacy of buffered and non-buffered local anaesthesia in the extraction of grossly decayed maxillary molar teeth in relation to pain on local infiltration, onset and duration of action of local anaesthesia. Materials and Methods: This is a prospective randomised controlled trial done on 100 patients who required bilateral extraction of maxillary molar teeth. In the study group, patients were given buffered local anaesthesia (which was prepared by mixing 2% lignocaine with 1:80,000 adrenaline and 8.4% sodium bicarbonate) before extraction. In the control group, non-buffered local anaesthesia (2% lignocaine with 1:80,000 adrenaline) was given before extraction. Results: Statistical data confirmed that buffering reduces pain on infiltration, decreases the onset and increases the duration of action of the local anaesthesia compared to non-buffered local anaesthesia. All the parameters measured were statistically significant (P = 0.001). Discussion: The study concludes that buffered local anaesthesia was more beneficial than non-buffered local anaesthesia in reducing pain on injection, providing a quicker onset of local anaesthesia and increasing the duration of action of the local anaesthesia. Buffering is a safe, easy and efficient process and should be routinely followed to provide a better experience to the patients.

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Buffered articaine infiltration for primary maxillary molar extractions: a randomized controlled study

Cited by 3 publications

References 10 publications

Buffered Versus Nonbuffered Local Anesthetics and Local Pain Scores in Upper Eyelid Blepharoplasty: Randomized Controlled Trial

Buffered Versus Nonbuffered Local Anesthetics and Local Pain Scores in Upper Eyelid Blepharoplasty: Randomized Controlled Trial

Anesthetic efficacy of buffered 4% articaine for mandibular first molar infiltration: a crossover clinical trial

Buffered versus Non-buffered Local Anaesthesia in Minor Oral Surgery - A Comparative Study

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