Pain assessment after application of 4% articaine with epinephrine 1:100000 during mandibular dental procedures

Abstract

Inferior alveolar nerve block in the mandibular technique is the blockade that presents most failures in the dental practice, so this technique is considered the less effective of those used in Dentistry and the most frustrating to the dentist. This study aimed to determine pain intensity during dental procedures after using 4% articaine with epinephrine 1:100000 in the inferior alveolar nerve block with buccal infiltration in patients who were attended in the dental clinic of the University of Cartagena, Colombia. A clinical randomized trial was performed. The sample was of patients who required dental procedures in the jaw with local anesthesia. After standardization of the anesthetic technique, and use of 4% articaine with epinephrine 1:100000, the inferior alveolar nerve was blocked with 0.9 mL (half cartridge) followed by buccal infiltration with 0.9 mL in the first mandibular molar. Fifty patients (30 men - 60% and 20 women - 40%), with an average age of 25.3 years old (mean ± standard deviation [SD]: 25.3 ± 6.6) were included in the study. When assessing the pain puncture and during the injection, 92% of patients classified it as mild pain according to VAS. When evaluating the latency period, the average time was less than two minutes and the perioral soft tissue anesthesia was 97%. Only a small percentage of patients required complementary anesthesia. The authors recommend the use of 4% of articaine with epinephrine in mandibular procedures that require deep pulp anesthesia, using this with a buccal infiltration.