Is Articaine More Potent than Mepivacaine for Use in Oral Surgery?

Abstract

ObjectivesTo investigate the potency and speed of action of 4% articaine and 2% mepivacaine for maxillary teeth extractions.Material and MethodsNinety-four patients, aged between 16 to 70 years old, were recruited in this study. Two regimens were randomly administered over one visit. Patients of treatment group 1 received mepivacaine 2% with 1:100,000 adrenaline, whereas treatment group 2 - articaine 4% with 1:100,000 adrenaline. The onset time of pulp anaesthesia for maxillary teeth indicated for extraction was determined by electronic pulp testing. At any point of trial (10 minutes), the anesthetized tooth becomes unresponsive for maximal pulp stimulation (64 reading), the extraction was carried out.ResultsIn this study, 85 patients had successful local anaesthetic followed by extraction within the study duration time (10 min). However, 5 patients had failed dental extraction (4 in mepivacaine group and 1 in articaine group). Patients in the articaine buccal infiltration group recorded faster onset time of action regarding anaesthesia and teeth extraction than patients in mepivacaine buccal infiltration group (P = 0.03).ConclusionsArticaine is an effective anaesthetic with a rapid onset, comparable to mepivacaine in infiltrative techniques used for maxillary teeth extraction. However, articaine has clinically achieved faster dental anaesthesia and earlier teeth extraction than mepivacaine. So, articaine can be the local anaesthetic of first choice in oral surgery.

Volume and effectiveness assessment of articain 4% versus mepivacaine 2% used in third molar surgery: randomized, double-blind, split-mouth controlled clinical trial

“…With regard to the anaesthetic onset time, there is a difference between articaine and mepivacaine in which 3.36 minutes and 4.09 minutes were observed, respectively. Moreover, anaesthetic onset times of 2,98 minutes for articaine and 4,22 minutes for mepivacaine were reported elsewhere ( 13 ), which differ from the results found by a clinical study showing that both drugs had a shorter onset time of 2.30 minutes ( 11 ).…”

“…There are a few studies in the literature comparing these anesthetic drugs and showing evidence that both allow a successful pain management ( 11 , 13 , 14 ).When comparing the volume of drug used and the anaesthetic action, studies have shown that there is a correlation between more use of drugs and greater anaesthetic efficacy in the pain management ( 15 ). Authors who evaluated changes in hemodynamic parameters using anesthetics found greater safety when lower volume and concentration of vasoconstrictor were employed ( 16 ).…”

“…Evaluation of and comparison between 4% articaine and 2% mepivacaine can help both patients and surgeons by assisting in the selection of anaesthetic drugs so that discomfort can be minimised and adverse events better managed during and after surgery, which consequently benefits the parties involved ( 9 , 11 , 13 ).…”

Does articaine, rather than prilocaine, increase the success rate of anaesthesia for extraction of maxillary teeth

“…On other hand, articaine is also an amide local anesthetic with a unique chemical structure. [ 18 ] The presence of thiophene ring in its chemical structure resulted in an increase in lipid solubility and diffusing better through soft tissues than do other anaesthetic, consequently, articaine achieves fast onset time of action along with deep nerve anesthesia. [ 8 ] Articaine is metabolized in the liver, but because of the extra ester bond, it is metabolized by cholinesterase in blood as well.…”

“…[ 8 ] Articaine is metabolized in the liver, but because of the extra ester bond, it is metabolized by cholinesterase in blood as well. [ 18 19 ] This characteristic is significant, particularly, for patients with liver disease. [ 19 ]…”