Efficacy of Articaine versus Lidocaine in Supplemental Infiltration for Mandibular First versus Second Molars with Irreversible Pulpitis: A Prospective, Randomized, Double-blind Clinical Trial

Shapiro, Michael; McDonald, Neville J.; Gardner, Richard; Peters, Mathilde C.; Botero, Tatiana M.

doi:10.1016/j.joen.2017.10.003

Cited by 26 publications

(24 citation statements)

References 27 publications

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“…(18) La técnica anestésica intrapulpar precisa de la exposición de la cámara pulpar, logra un efecto de corta duración y resulta dolorosa; sin embargo, la infiltración de una inyección intraligamentaria se considera una buena opción cuando falla el BNAI, pero debe contarse con jeringas exclusivas a presión con mejores resultados cuando es asistida por ordenador. (19,20) La medición del nivel de intensidad del dolor utilizando la escala visual análoga de Heft Parker (EVA) resulta un método adecuado según varios autores; (6,12,16,17,19) aunque, Rosenberg et al (21) señalan que garantiza la predicción de la eficacia clínica de la anestesia. Cohen et al (11) mencionan que la falta de respuesta a estímulos como el adormecimiento del labio no constituyen un indicativo categórico de efectividad, sería preferible considerar la respuesta al dolor durante el acceso a la cámara pulpar.…”

Section: Discussionunclassified

Anestesia complementaria durante bloqueos fallidos del nervio alveolar inferior en casos de pulpitis irreversible

2020

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Los investigadores realizaron un estudio con enfoque mixto, de tipo no experimental descriptivo; cuya población estuvo constituida por la totalidad de historias clínicas de pacientes que asistieron a la Clínica de Atención Odontológica de la Universidad Regional Autónoma de los Andes, durante la campaña de atención gratuita ejecutada en el periodo abril-agosto 2019, de los que se seleccionaron 30 historias clínicas mediante un muestreo no probabilístico en base a criterios. La misma tuvo el objetivo de caracterizar el uso anestésico de las infiltraciones vestibulares e intraligamentarias utilizando articaína al 4% con epinefrina 1: 100 000, en molares y premolares inferiores diagnosticados con PI, después de un bloqueo fallido del nervio alveolar inferior en el contexto investigado. Sin un margen estadísticamente no significativo, en el caso de las mujeres, la inyección intraligamentaria mostró mejores resultados por (p= 0,109). La inyección intraligamentaria resultó más efectiva en los premolares (p=0,847). La inyección intraligamentaria obtuvo un 86,7% de éxito anestésico, mientras la infiltración vestibular lo fue en un 80% con respecto a la totalidad de la muestra donde se aplicaron (p=0,624).

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Section: Discussionunclassified

Anestesia complementaria durante bloqueos fallidos del nervio alveolar inferior en casos de pulpitis irreversible

2020

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“…Finally, the percentage reductions in BP were higher in the infiltration group than in the blocking group at all visits, but the differences were not significant, and this result disagrees with Huang et al in 2017,6 which showed a higher percentage reduction in the block anesthesia group than in the infiltration group, with nonsignificant differences. Rogers et al in 201421 and Shapiro et al in 201822 were found that the success rate of anesthesia was increased with the using of both inferior dental blocking and supplemental buccal infiltration than inferior dental blocking only to anesthetized mandibular molars teeth with irreversible pulpitis during access opening visit. This may be related to the nature of the bone of the maxilla, which is cancellous and trabecular or spongy, while the mandibular bone is compact,23 so infiltration anesthesia is faster and more effective than blocking, and patients given blocking anesthesia are probably more anxious and fearful when undergoing root canal treatment than are patients receiving infiltration anesthesia, which positively influenced BP reduction in the infiltration group 24…”

Section: Discussionmentioning

confidence: 99%

<p>The influence of endodontic treatment on blood pressure reduction in patients with vital irreversible pulpitis</p>

Hussein

Raafat

Amory

et al. 2019

CCIDE

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Background During endodontic treatment, endodontists must be aware of the various factors that may decrease or increase blood pressure. This study aimed to assess the mean percentages of systolic, diastolic, and arterial blood pressure (MSBP, MDAP, MABP) reduction in patients with vital irreversible pulpitis in teeth and who were treated at three visits to endodontists in three age groups (20–34 years, 35–50 years, 51–65 years). Materials and methods A total of 100 teeth with vital irreversible pulpitis from 100 patients were included. All patients underwent 3 visits for endodontic treatment. The 1st visit included removal of vital pulp tissue and a determination of working length, the 2nd visit included canal preparation and widening, and at the 3rd visit the canal was obturated and sealed by gutta percha and sealer. Blood pressure for all patients was checked and documented once before starting treatment and three times during treatment at different intervals during all visits. Results There were significantly higher percentage reductions in MSBP, MDBP, and MABP at the 1st visit for endodontic treatment in comparison to other visits (2nd and 3rd) for all patients. Additionally, there were significantly higher percentage reductions in MSBP, MDBP, and MABP at the 1st visit for endodontic treatment in comparison to other visits in males and females, for all age groups, both anesthesia injection-type groups (infiltration and block), and all treated tooth types except mandibular anterior teeth, and there were nonsignificant differences among groups. However, there were nonsignificant differences in MSBP, MDBP, and MABP between males and females, between infiltration and block injection groups and in relation to teeth types at all visits. Conclusions The reduction of blood pressure in patients undergoing endodontic treatment of vital teeth with irreversible pulpits is common, especially at the 1st visit for pulp extirpation.

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“…However, IANB does not always result in successful pulpal anesthesia (Claffey et al, 2004;Fowler & Reader, 2013;Oleson et al, 2010;Rogers, Botero, McDonald, Gardner, & Peters, 2014). Teeth with symptomatic irreversible pulpitis (SIP) show greater difficulty in achieving anesthesia during endodontic treatment (Abazarpoor, Parirokh, Nakhaee, & Abbott, 2015;Modaresi, Dianat, & Soluti, 2008;Shapiro, McDonald, Gardner, Peters, & Botero, 2018). Recent clinical studies in patients with SIP in mandibular molars have shown failure rates of IANB from 67% to 77% (Aggarwal, Jain, & Kabi, 2009;Aggarwal, Singla, & Miglani, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Professionals need to consider complementary techniques when the IANB fails to provide pulpal anesthesia for patients with SIP (Matthews, Drum, Reader, Nusstein, & Beck, 2009). In order to increase anesthetic success rates, various supplementary injection techniques have been used (Aggarwal, Singla, Miglani, & Kohli, 2019), including intraosseous, intrapulpal (Rogers et al, 2014;Shapiro et al, 2018), intraligamentary injections and buccal infiltrations (BI) (Webster et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Anesthetic efficacy of 4% articaine buccal infiltration in the urgency treatment of mandibular molars with symptomatic irreversible pulpitis: a randomized clinical trial

Capitânio

Tookuni

Pavan

et al. 2021

RSD

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The aim of this study was to evaluate the anesthetic efficacy of the 4% articaine by the buccal infiltration technique (BI) after inferior alveolar nerve block (IANB) with 2% mepivacaine, both with 1:100,000 epinephrine, in the urgency treatment of mandibular molars with symptomatic irreversible pulpitis (SIP). This was a prospective study, with a randomized, blinded, controlled parallel clinical trial experimental design. Thirty patients diagnosed with SIP were randomly assigned, and the control group (G1) received the IANB with 1.8 mL of mepivacaine while the experimental group (G2) also received a supplemental BI with 1.8 mL of articaine. To evaluate the anesthetic efficacy, in addition to lip numbness test, the electric pulp testing (EPT) was used. Additionally, a visual analogue scale verified the presence of pain. Two-way ANOVA and Chi-square tests were applied at a significance level of 5%. There was a reduction in pain perception after the two techniques (p<0.001), with no difference between groups (p=0.479). The anesthetic efficacy was 26.6% for IANB (G1) and 40% for IANB plus BI (G2), without significant difference between the two treatments (p=0.699). The BI with 4% articaine after IANB with 2% mepivacaine, both with 1:100,000 epinephrine, did not significantly increase anesthetic success in patients with SIP.

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Efficacy of Articaine versus Lidocaine in Supplemental Infiltration for Mandibular First versus Second Molars with Irreversible Pulpitis: A Prospective, Randomized, Double-blind Clinical Trial

Cited by 26 publications

References 27 publications

Anestesia complementaria durante bloqueos fallidos del nervio alveolar inferior en casos de pulpitis irreversible

Anestesia complementaria durante bloqueos fallidos del nervio alveolar inferior en casos de pulpitis irreversible

<p>The influence of endodontic treatment on blood pressure reduction in patients with vital irreversible pulpitis</p>

Anesthetic efficacy of 4% articaine buccal infiltration in the urgency treatment of mandibular molars with symptomatic irreversible pulpitis: a randomized clinical trial

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