Double versus single cartridge of 4% articaine infiltration into the retro-molar area for lower third molar surgery

Abstract

BackgroundThere are no studies regarding 4% articaine infiltration injection into the retro-molar area for an impacted lower third molar (LITM) surgery. This study aimed to evaluate the efficacy of infiltration using 1.7 ml (single cartridge: SC) of 4% articaine versus 3.4 ml (double cartridges: DC) of 4% articaine with 1:100,000 epinephrine in LITM surgery.MethodThis study involved 30 healthy patients with symmetrical LITM. The patients were assigned to receive either a DC or SC of 4% articaine with 1:100,000 epinephrine as a local anesthetic for each operation. Onset, duration, profoundness, need for additional anesthetic administration, total volume of anesthetic used, vitality of the tooth, and pain score during operation were recorded.ResultsThe DC of 4 % articaine had a significantly higher success rate (83.3%) than did the SC (53.3%; P < 0.05). The duration of soft tissue anesthesia was longer in the DC group. The intra-operative pain was higher in the SC group with a significant (P < 0.05) requirement for a supplementary local anesthetic.ConclusionWe concluded that using DC for the infiltration injection had a higher success rate, longer duration of anesthesia, less intra-operative pain, and a lower amount of additional anesthesia than SC in the surgical removal of LITM. We recommend that a DC of 4% articaine and a 1:100,000 epinephrine infiltration in the retro-molar region can be an alternative anesthetic for LITM surgery.

Anesthetic Efficiency of Articaine Versus Lidocaine in the Extraction of Lower Third Molars: A Meta-Analysis and Systematic Review

“…34 Three studies reported that the dosage of anesthesia could affect the efficiency of anesthesia, in that a greater volume could increase anesthetic efficiency. [28][29][30] This is because a higher volume of the anesthetic agent may yield a higher concentration of the anesthetic agent in the pterygomandibular space. 29 Moreover, Al-Shayyab et al 35 found that many factors could affect the onset time and duration of action of local anesthesia, such as age, gender, and smoking status.…”

“…[21][22][23][24][25][26][27] The pooled outcomes for SOA showed that articaine resulted in shorter SOA than lidocaine, as shown in Figure 4A (SMD, 1.20; 95% CI, 0.50 to 1.89; P = .0007), but with high total heterogeneity (I 2 = 94%, P < .00001) and high heterogeneity for the 2L100 subgroup (I 2 = 95%, P < .00001), so we conducted a sensitivity analysis and found no obvious heterogeneity to change. According to the findings of 3 studies, [28][29][30] we knew a greater dosage could cause more anesthesia efficiency for lidocaine and articaine in LTME. Thus, the dosage used was likely the main cause of the remaining heterogeneity.…”

The anesthetic efficiency of retromolar infiltrations with two local anesthetic solutions of the same concentration in lower third molar surgery

“…Their results showed an 83.3% success rate in the 3.4ml group, which had a longer soft-tissue anesthesia interval and less intraoperative pain, and a 53.3% success rate in the 1.7 ml group. In the conclusion of this study, the researchers suggested that infiltration using 3.4 ml of 4% articaine in the retromolar region can be an effective alternative practice for MTMS [12].…”

A Ação Dos Antidepressivos Sobre a Hemostasia

“…A maioria dos estudos utiliza a escala visual analógica (EVA) ou do inglês Visual Analogic Scale (VAS) como meio de avaliação para a resposta dolorosa, falha na anestesia, índice de sucesso, satisfação do paciente e desempenho analgésico. Neste método o paciente passa a ser indiretamente o avaliador do desempenho anestésico (Costa et al, 2005 (Singla et al, 2014) e outro estudo que relata o contrário, onde chegaram a conclusão que utilizando dois tubetes de solução aumenta a taxa de sucesso, tem uma maior duração da anestesia e menos dor durante procedimento cirúrgico (Sawang et al, 2017). Com relação aos efeitos adversos, há relatos na literatura de alguns efeitos após o uso da articaína, como neuropatias envolvendo lábios e línguas (Miller & Lennon, 2000), parestesias e hiperestesias (Malamed et al, 2005), como também a contra-indicação do uso para pacientes com alergia aos antimicrobianos derivados da sulfa e aos sulfitos (Wohrl et al, 2006).…”