The Experts below are selected from a list of 1080 Experts worldwide ranked by ideXlab platform
Mike Beck - One of the best experts on this subject based on the ideXlab platform.
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Buffered 4% Articaine as a Primary Buccal Infiltration of the Mandibular First Molar: A Prospective, Randomized, Double-blind Study.
Journal of Endodontics, 2015Co-Authors: Ryan Shurtz, Sara Fowler, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction Articaine is superior to lidocaine when used as a primary buccal infiltration of the mandibular first molar. Buffered local anesthetics have been purported to improve anesthetic success. Buffering a 4% Articaine formulation may increase the success of a mandibular first molar buccal infiltration. The purpose of this study was to compare the degree of pulpal anesthesia obtained with a buffered 4% Articaine with 1:100,000 epinephrine formulation versus a nonbuffered 4% Articaine with 1:100,000 epinephrine formulation as a primary buccal infiltration of the mandibular first molar. Methods Eighty adults randomly received mandibular buccal infiltrations using 4% Articaine with 100,000 epinephrine buffered with 8.4% sodium bicarbonate (18 mEq) and 4% Articaine with 1:100,000 epinephrine in a double-blind manner at 2 separate appointments. An electric pulp tester was used to test the first molar for pulpal anesthesia every 30 seconds for the first 5 minutes and every minute for the remaining 55 minutes. Successful pulpal anesthesia was defined as 2 consecutive 80/80 readings with the electric pulp tester. Pain ratings for each injection were recorded as well as the onset time of pulpal anesthesia. Results Anesthetic success rates for buffered Articaine and nonbuffered Articaine were 71% and 65%, respectively. There was no significant difference between the formulations ( P = .3018). No significant differences were found between the 2 formulations for pain of injection or onset of anesthesia. Conclusions Buffered Articaine did not provide any advantage over nonbuffered Articaine for anesthetic success, anesthesia onset, or pain of injection for a primary buccal infiltration of the mandibular first molar.
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anesthetic comparisons of 4 concentrations of Articaine lidocaine and prilocaine as primary buccal infiltrations of the mandibular first molar a prospective randomized double blind study
Journal of Endodontics, 2014Co-Authors: Brett Nydegger, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction Studies have shown the superiority of 4% Articaine with 1:100,000 epinephrine over 2% lidocaine with 1:100,000 epinephrine when used as a primary buccal infiltration of the mandibular first molar. A study using other 4% anesthetic formulations may help determine the role of concentration in the increased efficacy of 4% Articaine. The authors conducted a prospective randomized, double-blind, crossover study comparing the pulpal anesthesia obtained with 4% concentrations of Articaine, lidocaine, and prilocaine formulations as primary buccal infiltrations of the mandibular first molar. Methods Sixty asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of 1.8 mL 4% Articaine with 1:100,000 epinephrine, 4% lidocaine with 1:100,000 epinephrine, and 4% prilocaine with 1:200,000 epinephrine in 3 separate appointments. An electric pulp tester was used to test the first molar for anesthesia in 3-minute cycles for 60 minutes after the infiltrations. Successful anesthesia was defined as 2 consecutive 80/80 readings. Results The success rate for the 4% Articaine formulation was 55%, 33% for the 4% lidocaine formulation, and 32% for the 4% prilocaine formulation. There was a significant difference between Articaine and both lidocaine ( P = .0071) and prilocaine ( P = .0187) formulations. Conclusions A 4% Articaine formulation was statistically better than both 4% lidocaine and 4% prilocaine formulations for buccal infiltration of the mandibular first molar in asymptomatic mandibular first molars. However, the success rate of 55% is not high enough to support its use as a primary buccal infiltration technique in the mandibular first molar.
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anesthetic efficacy of 1 8 ml versus 3 6 ml of 4 Articaine with 1 100 000 epinephrine as a primary buccal infiltration of the mandibular first molar
Journal of Endodontics, 2011Co-Authors: Matthew Martin, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction No study has compared 1.8 mL and 3.6 mL 4% Articaine with 1:100,000 epinephrine in a mandibular buccal infiltration of the first molar. The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 1.8 mL and 3.6 mL 4% Articaine with 1:100,000 epinephrine as a primary infiltration in the mandibular first molar. Methods Eighty-six asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of 1.8 mL or 3.6 mL 4% Articaine with 1:100,000 epinephrine in two separate appointments. The authors used an electric pulp tester to test the first molar for anesthesia in 3-minute cycles for 90 minutes after the injections. Results Compared with the 1.8-mL volume of 4% Articaine with 1:100,000 epinephrine, the 3.6-mL volume showed a statistically higher success rate (70% vs 50%). Conclusions The anesthetic efficacy of 3.6 mL 4% Articaine with 1:100,000 epinephrine is better than 1.8 mL of the same anesthetic solution in a primary mandibular buccal infiltration of the first molar. However, the success rate of 70% is not high enough to support its use as a primary injection technique in the mandibular first molar.
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anesthetic efficacy of 4 Articaine with 1 100 000 epinephrine versus 4 Articaine with 1 200 000 epinephrine as a primary buccal infiltration in the mandibular first molar
Journal of Endodontics, 2011Co-Authors: Melissa Drum, Al Reader, John Nusstein, Mayes Mcentire, Mike BeckAbstract:Abstract Introduction No study has compared 4% Articaine with 1:100,000 epinephrine with 4% Articaine with 1:200,000 epinephrine in a mandibular buccal infiltration of the first molar. The authors conducted a prospective, randomized, double-blind, crossover study comparing the degree of pulpal anesthesia obtained with 4% Articaine with 1:100,000 epinephrine and 4% Articaine with 1:200,000 epinephrine as a primary infiltration in the mandibular first molar. Methods Eighty-six asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of a cartridge of 4% Articaine with 1:100,000 epinephrine and a cartridge of 4% Articaine with 1:200,000 epinephrine in 2 separate appointments. The authors used an electric pulp tester to test the first molar for anesthesia in 3-minute cycles for 60 minutes after the injections. Results The two 4% Articaine formulations showed no statistically significant difference when comparing anesthetic success, onset of anesthesia, or incidence of pulpal anesthesia. Conclusions The anesthetic efficacy of 4% Articaine with 1:200,000 epinephrine is comparable to 4% Articaine with 1:100,000 epinephrine in a primary mandibular buccal infiltration of the first molar.
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Anesthetic Efficacy of Articaine for Combination Labial Plus Lingual Infiltrations versus Labial Infiltration in the Mandibular Lateral Incisor
Journal of Endodontics, 2010Co-Authors: Frederick Micah Nuzum, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction Previous studies have shown higher success rates when using an Articaine formulation versus a lidocaine formulation for buccal mandibular first molar infiltrations. However, there is little information on Articaine's effect in mandibular anterior teeth. Methods The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 2 sets of mandibular lateral incisor infiltrations given in 2 separate appointments in 82 adult subjects. One set of infiltrations consisted of an initial labial infiltration of a cartridge of 4% Articaine with 1:100,000 epinephrine plus a lingual infiltration of the same anesthetic and dose. The other set of infiltrations consisted of an initial labial infiltration of a cartridge of 4% Articaine with 1:100,000 epinephrine plus a mock lingual infiltration. The authors used an electric pulp tester to test the lateral incisor for pulpal anesthesia in 2-minute cycles for 60 minutes after the injections. Results and Conclusions The labial plus lingual infiltration significantly improved the success rate (no response to 2 consecutive 80 readings with the pulp tester) to 98% when compared with a labial infiltration of a cartridge of the same Articaine formulation (76% success). The combination labial and lingual infiltrations did not provide pulpal anesthesia for an hour.
John Nusstein - One of the best experts on this subject based on the ideXlab platform.
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Buffered 4% Articaine as a Primary Buccal Infiltration of the Mandibular First Molar: A Prospective, Randomized, Double-blind Study.
Journal of Endodontics, 2015Co-Authors: Ryan Shurtz, Sara Fowler, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction Articaine is superior to lidocaine when used as a primary buccal infiltration of the mandibular first molar. Buffered local anesthetics have been purported to improve anesthetic success. Buffering a 4% Articaine formulation may increase the success of a mandibular first molar buccal infiltration. The purpose of this study was to compare the degree of pulpal anesthesia obtained with a buffered 4% Articaine with 1:100,000 epinephrine formulation versus a nonbuffered 4% Articaine with 1:100,000 epinephrine formulation as a primary buccal infiltration of the mandibular first molar. Methods Eighty adults randomly received mandibular buccal infiltrations using 4% Articaine with 100,000 epinephrine buffered with 8.4% sodium bicarbonate (18 mEq) and 4% Articaine with 1:100,000 epinephrine in a double-blind manner at 2 separate appointments. An electric pulp tester was used to test the first molar for pulpal anesthesia every 30 seconds for the first 5 minutes and every minute for the remaining 55 minutes. Successful pulpal anesthesia was defined as 2 consecutive 80/80 readings with the electric pulp tester. Pain ratings for each injection were recorded as well as the onset time of pulpal anesthesia. Results Anesthetic success rates for buffered Articaine and nonbuffered Articaine were 71% and 65%, respectively. There was no significant difference between the formulations ( P = .3018). No significant differences were found between the 2 formulations for pain of injection or onset of anesthesia. Conclusions Buffered Articaine did not provide any advantage over nonbuffered Articaine for anesthetic success, anesthesia onset, or pain of injection for a primary buccal infiltration of the mandibular first molar.
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anesthetic comparisons of 4 concentrations of Articaine lidocaine and prilocaine as primary buccal infiltrations of the mandibular first molar a prospective randomized double blind study
Journal of Endodontics, 2014Co-Authors: Brett Nydegger, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction Studies have shown the superiority of 4% Articaine with 1:100,000 epinephrine over 2% lidocaine with 1:100,000 epinephrine when used as a primary buccal infiltration of the mandibular first molar. A study using other 4% anesthetic formulations may help determine the role of concentration in the increased efficacy of 4% Articaine. The authors conducted a prospective randomized, double-blind, crossover study comparing the pulpal anesthesia obtained with 4% concentrations of Articaine, lidocaine, and prilocaine formulations as primary buccal infiltrations of the mandibular first molar. Methods Sixty asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of 1.8 mL 4% Articaine with 1:100,000 epinephrine, 4% lidocaine with 1:100,000 epinephrine, and 4% prilocaine with 1:200,000 epinephrine in 3 separate appointments. An electric pulp tester was used to test the first molar for anesthesia in 3-minute cycles for 60 minutes after the infiltrations. Successful anesthesia was defined as 2 consecutive 80/80 readings. Results The success rate for the 4% Articaine formulation was 55%, 33% for the 4% lidocaine formulation, and 32% for the 4% prilocaine formulation. There was a significant difference between Articaine and both lidocaine ( P = .0071) and prilocaine ( P = .0187) formulations. Conclusions A 4% Articaine formulation was statistically better than both 4% lidocaine and 4% prilocaine formulations for buccal infiltration of the mandibular first molar in asymptomatic mandibular first molars. However, the success rate of 55% is not high enough to support its use as a primary buccal infiltration technique in the mandibular first molar.
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anesthetic efficacy of 1 8 ml versus 3 6 ml of 4 Articaine with 1 100 000 epinephrine as a primary buccal infiltration of the mandibular first molar
Journal of Endodontics, 2011Co-Authors: Matthew Martin, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction No study has compared 1.8 mL and 3.6 mL 4% Articaine with 1:100,000 epinephrine in a mandibular buccal infiltration of the first molar. The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 1.8 mL and 3.6 mL 4% Articaine with 1:100,000 epinephrine as a primary infiltration in the mandibular first molar. Methods Eighty-six asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of 1.8 mL or 3.6 mL 4% Articaine with 1:100,000 epinephrine in two separate appointments. The authors used an electric pulp tester to test the first molar for anesthesia in 3-minute cycles for 90 minutes after the injections. Results Compared with the 1.8-mL volume of 4% Articaine with 1:100,000 epinephrine, the 3.6-mL volume showed a statistically higher success rate (70% vs 50%). Conclusions The anesthetic efficacy of 3.6 mL 4% Articaine with 1:100,000 epinephrine is better than 1.8 mL of the same anesthetic solution in a primary mandibular buccal infiltration of the first molar. However, the success rate of 70% is not high enough to support its use as a primary injection technique in the mandibular first molar.
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anesthetic efficacy of 4 Articaine with 1 100 000 epinephrine versus 4 Articaine with 1 200 000 epinephrine as a primary buccal infiltration in the mandibular first molar
Journal of Endodontics, 2011Co-Authors: Melissa Drum, Al Reader, John Nusstein, Mayes Mcentire, Mike BeckAbstract:Abstract Introduction No study has compared 4% Articaine with 1:100,000 epinephrine with 4% Articaine with 1:200,000 epinephrine in a mandibular buccal infiltration of the first molar. The authors conducted a prospective, randomized, double-blind, crossover study comparing the degree of pulpal anesthesia obtained with 4% Articaine with 1:100,000 epinephrine and 4% Articaine with 1:200,000 epinephrine as a primary infiltration in the mandibular first molar. Methods Eighty-six asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of a cartridge of 4% Articaine with 1:100,000 epinephrine and a cartridge of 4% Articaine with 1:200,000 epinephrine in 2 separate appointments. The authors used an electric pulp tester to test the first molar for anesthesia in 3-minute cycles for 60 minutes after the injections. Results The two 4% Articaine formulations showed no statistically significant difference when comparing anesthetic success, onset of anesthesia, or incidence of pulpal anesthesia. Conclusions The anesthetic efficacy of 4% Articaine with 1:200,000 epinephrine is comparable to 4% Articaine with 1:100,000 epinephrine in a primary mandibular buccal infiltration of the first molar.
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Anesthetic Efficacy of Articaine for Combination Labial Plus Lingual Infiltrations versus Labial Infiltration in the Mandibular Lateral Incisor
Journal of Endodontics, 2010Co-Authors: Frederick Micah Nuzum, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction Previous studies have shown higher success rates when using an Articaine formulation versus a lidocaine formulation for buccal mandibular first molar infiltrations. However, there is little information on Articaine's effect in mandibular anterior teeth. Methods The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 2 sets of mandibular lateral incisor infiltrations given in 2 separate appointments in 82 adult subjects. One set of infiltrations consisted of an initial labial infiltration of a cartridge of 4% Articaine with 1:100,000 epinephrine plus a lingual infiltration of the same anesthetic and dose. The other set of infiltrations consisted of an initial labial infiltration of a cartridge of 4% Articaine with 1:100,000 epinephrine plus a mock lingual infiltration. The authors used an electric pulp tester to test the lateral incisor for pulpal anesthesia in 2-minute cycles for 60 minutes after the injections. Results and Conclusions The labial plus lingual infiltration significantly improved the success rate (no response to 2 consecutive 80 readings with the pulp tester) to 98% when compared with a labial infiltration of a cartridge of the same Articaine formulation (76% success). The combination labial and lingual infiltrations did not provide pulpal anesthesia for an hour.
Al Reader - One of the best experts on this subject based on the ideXlab platform.
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Buffered 4% Articaine as a Primary Buccal Infiltration of the Mandibular First Molar: A Prospective, Randomized, Double-blind Study.
Journal of Endodontics, 2015Co-Authors: Ryan Shurtz, Sara Fowler, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction Articaine is superior to lidocaine when used as a primary buccal infiltration of the mandibular first molar. Buffered local anesthetics have been purported to improve anesthetic success. Buffering a 4% Articaine formulation may increase the success of a mandibular first molar buccal infiltration. The purpose of this study was to compare the degree of pulpal anesthesia obtained with a buffered 4% Articaine with 1:100,000 epinephrine formulation versus a nonbuffered 4% Articaine with 1:100,000 epinephrine formulation as a primary buccal infiltration of the mandibular first molar. Methods Eighty adults randomly received mandibular buccal infiltrations using 4% Articaine with 100,000 epinephrine buffered with 8.4% sodium bicarbonate (18 mEq) and 4% Articaine with 1:100,000 epinephrine in a double-blind manner at 2 separate appointments. An electric pulp tester was used to test the first molar for pulpal anesthesia every 30 seconds for the first 5 minutes and every minute for the remaining 55 minutes. Successful pulpal anesthesia was defined as 2 consecutive 80/80 readings with the electric pulp tester. Pain ratings for each injection were recorded as well as the onset time of pulpal anesthesia. Results Anesthetic success rates for buffered Articaine and nonbuffered Articaine were 71% and 65%, respectively. There was no significant difference between the formulations ( P = .3018). No significant differences were found between the 2 formulations for pain of injection or onset of anesthesia. Conclusions Buffered Articaine did not provide any advantage over nonbuffered Articaine for anesthetic success, anesthesia onset, or pain of injection for a primary buccal infiltration of the mandibular first molar.
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anesthetic comparisons of 4 concentrations of Articaine lidocaine and prilocaine as primary buccal infiltrations of the mandibular first molar a prospective randomized double blind study
Journal of Endodontics, 2014Co-Authors: Brett Nydegger, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction Studies have shown the superiority of 4% Articaine with 1:100,000 epinephrine over 2% lidocaine with 1:100,000 epinephrine when used as a primary buccal infiltration of the mandibular first molar. A study using other 4% anesthetic formulations may help determine the role of concentration in the increased efficacy of 4% Articaine. The authors conducted a prospective randomized, double-blind, crossover study comparing the pulpal anesthesia obtained with 4% concentrations of Articaine, lidocaine, and prilocaine formulations as primary buccal infiltrations of the mandibular first molar. Methods Sixty asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of 1.8 mL 4% Articaine with 1:100,000 epinephrine, 4% lidocaine with 1:100,000 epinephrine, and 4% prilocaine with 1:200,000 epinephrine in 3 separate appointments. An electric pulp tester was used to test the first molar for anesthesia in 3-minute cycles for 60 minutes after the infiltrations. Successful anesthesia was defined as 2 consecutive 80/80 readings. Results The success rate for the 4% Articaine formulation was 55%, 33% for the 4% lidocaine formulation, and 32% for the 4% prilocaine formulation. There was a significant difference between Articaine and both lidocaine ( P = .0071) and prilocaine ( P = .0187) formulations. Conclusions A 4% Articaine formulation was statistically better than both 4% lidocaine and 4% prilocaine formulations for buccal infiltration of the mandibular first molar in asymptomatic mandibular first molars. However, the success rate of 55% is not high enough to support its use as a primary buccal infiltration technique in the mandibular first molar.
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anesthetic efficacy of 1 8 ml versus 3 6 ml of 4 Articaine with 1 100 000 epinephrine as a primary buccal infiltration of the mandibular first molar
Journal of Endodontics, 2011Co-Authors: Matthew Martin, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction No study has compared 1.8 mL and 3.6 mL 4% Articaine with 1:100,000 epinephrine in a mandibular buccal infiltration of the first molar. The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 1.8 mL and 3.6 mL 4% Articaine with 1:100,000 epinephrine as a primary infiltration in the mandibular first molar. Methods Eighty-six asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of 1.8 mL or 3.6 mL 4% Articaine with 1:100,000 epinephrine in two separate appointments. The authors used an electric pulp tester to test the first molar for anesthesia in 3-minute cycles for 90 minutes after the injections. Results Compared with the 1.8-mL volume of 4% Articaine with 1:100,000 epinephrine, the 3.6-mL volume showed a statistically higher success rate (70% vs 50%). Conclusions The anesthetic efficacy of 3.6 mL 4% Articaine with 1:100,000 epinephrine is better than 1.8 mL of the same anesthetic solution in a primary mandibular buccal infiltration of the first molar. However, the success rate of 70% is not high enough to support its use as a primary injection technique in the mandibular first molar.
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anesthetic efficacy of 4 Articaine with 1 100 000 epinephrine versus 4 Articaine with 1 200 000 epinephrine as a primary buccal infiltration in the mandibular first molar
Journal of Endodontics, 2011Co-Authors: Melissa Drum, Al Reader, John Nusstein, Mayes Mcentire, Mike BeckAbstract:Abstract Introduction No study has compared 4% Articaine with 1:100,000 epinephrine with 4% Articaine with 1:200,000 epinephrine in a mandibular buccal infiltration of the first molar. The authors conducted a prospective, randomized, double-blind, crossover study comparing the degree of pulpal anesthesia obtained with 4% Articaine with 1:100,000 epinephrine and 4% Articaine with 1:200,000 epinephrine as a primary infiltration in the mandibular first molar. Methods Eighty-six asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of a cartridge of 4% Articaine with 1:100,000 epinephrine and a cartridge of 4% Articaine with 1:200,000 epinephrine in 2 separate appointments. The authors used an electric pulp tester to test the first molar for anesthesia in 3-minute cycles for 60 minutes after the injections. Results The two 4% Articaine formulations showed no statistically significant difference when comparing anesthetic success, onset of anesthesia, or incidence of pulpal anesthesia. Conclusions The anesthetic efficacy of 4% Articaine with 1:200,000 epinephrine is comparable to 4% Articaine with 1:100,000 epinephrine in a primary mandibular buccal infiltration of the first molar.
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Anesthetic Efficacy of Articaine for Combination Labial Plus Lingual Infiltrations versus Labial Infiltration in the Mandibular Lateral Incisor
Journal of Endodontics, 2010Co-Authors: Frederick Micah Nuzum, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Abstract Introduction Previous studies have shown higher success rates when using an Articaine formulation versus a lidocaine formulation for buccal mandibular first molar infiltrations. However, there is little information on Articaine's effect in mandibular anterior teeth. Methods The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 2 sets of mandibular lateral incisor infiltrations given in 2 separate appointments in 82 adult subjects. One set of infiltrations consisted of an initial labial infiltration of a cartridge of 4% Articaine with 1:100,000 epinephrine plus a lingual infiltration of the same anesthetic and dose. The other set of infiltrations consisted of an initial labial infiltration of a cartridge of 4% Articaine with 1:100,000 epinephrine plus a mock lingual infiltration. The authors used an electric pulp tester to test the lateral incisor for pulpal anesthesia in 2-minute cycles for 60 minutes after the injections. Results and Conclusions The labial plus lingual infiltration significantly improved the success rate (no response to 2 consecutive 80 readings with the pulp tester) to 98% when compared with a labial infiltration of a cartridge of the same Articaine formulation (76% success). The combination labial and lingual infiltrations did not provide pulpal anesthesia for an hour.
John Gerard Meechan - One of the best experts on this subject based on the ideXlab platform.
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a comparison of the efficacy of 4 Articaine with 1 100 000 epinephrine and 2 lidocaine with 1 80 000 epinephrine in achieving pulpal anesthesia in maxillary teeth with irreversible pulpitis
Journal of Endodontics, 2012Co-Authors: Mohammad Dib Kanaa, J M Whitworth, John Gerard MeechanAbstract:Abstract Introduction To assess the efficacy of buccal infiltrations of 4% Articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine in achieving anesthesia in maxillary teeth with irreversible pulpitis. Methods This randomized double-blind clinical trial included 100 patients diagnosed with irreversible pulpitis in maxillary teeth. Patients received 2.0 mL 4% Articaine with 1:100,000 epinephrine or 2% lidocaine with 1:80,000 epinephrine in the buccal sulcus adjacent to the tooth with pulpitis. Before and every 2 minutes up to a maximum of 10 minutes after injection, the response of the test tooth was assessed using an electronic pulp tester. Successful pulp anesthesia was considered to have occurred when no response was obtained to the maximum stimulation (80 reading) of the pulp tester during the test period, at which time treatment commenced. Treatment was regarded as being successfully completed when it was associated with no pain. The time to onset of successful pulp anesthesia was recorded for each test tooth. Injection discomfort was recorded on standard 100-mm visual analog scales (VASs). Data were analyzed by the Chi-square and Student t tests. Results Fifty patients received Articaine and 50 received lidocaine. Seventy-three of the 100 patients achieved pulpal anesthesia within 10 minutes of injection: 38 after Articaine and 35 after lidocaine ( P = .5). The onset of pulpal anesthesia after Articaine and lidocaine buccal infiltrations was similar (mean and standard deviations: 4.9 ± 2.7 minutes vs 5.1 ± 2.4 minutes, respectively; t = 0.2; P = .82). Pain-free treatment was completed in 33 patients after Articaine and 29 after lidocaine buccal infiltrations ( P = .63). Although Articaine buccal injection was significantly more comfortable than lidocaine buccal injection ( t = 2.3, P = .026), both were associated with mild discomfort on VAS (means ± standard deviation: 10.8 mm ± 11.7 mm vs 17.5 mm ± 17.6 mm, respectively). Conclusions There was no significant difference in efficacy between 4% Articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine in achieving anesthesia in maxillary teeth with irreversible pulpitis after buccal infiltration.
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Articaine buccal infiltration enhances the effectiveness of lidocaine inferior alveolar nerve block
International Endodontic Journal, 2009Co-Authors: Mohammad Dib Kanaa, I. P. Corbett, J M Whitworth, John Gerard MeechanAbstract:Aim To compare mandibular tooth pulpal anaesthesia and reported discomfort following lidocaine inferior alveolar nerve block (IANB) with and without supplementary Articaine buccal infiltration. Methodology In this prospective randomized double-blind cross-over study, thirty-six healthy adult volunteers received two IANB injections of 2 mL lidocaine 2% with epinephrine 1 : 80 000 over two visits. At one visit, an infiltration of 2 mL of Articaine 4% with epinephrine 1 : 100 000 was administered in the mucobuccal fold opposite a mandibular first molar. At the other visit, a dummy injection was performed. Injection discomfort was recorded on 100 mm visual analogue scales. Pulpal anaesthesia of first molar, premolar, and lateral incisor teeth was assessed with an electronic pulp tester until 45 min post-injection. A successful outcome was recorded in the absence of sensation on two or more consecutive maximal pulp tester stimulations. Data were analysed using McNemar and Student’s t-tests. Results The IANB with supplementary Articaine infiltration produced more success than IANB alone in first molars (33 volunteers vs. 20 volunteers respectively, P < 0.001), premolars (32 volunteers vs. 24 volunteers respectively, P = 0.021) and lateral incisors (28 volunteers vs. 7 volunteers respectively, P < 0.001). Buccal infiltration with Articaine or dummy injection produced less discomfort than IANB injection (t = 4.1, P < 0.001; t = 3.0, P = 0.005 respectively). Conclusions The IANB injection supplemented with Articaine buccal infiltration was more successful than IANB alone for pulpal anaesthesia in mandibular teeth. Articaine buccal infiltration or dummy buccal infiltration was more comfortable than IANB.
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Articaine infiltration for anesthesia of mandibular first molars.
Journal of endodontics, 2008Co-Authors: I. P. Corbett, Mohammad Dib Kanaa, John Whitworth, John Gerard MeechanAbstract:A randomized, controlled trial of 31 healthy volunteers compared 4% Articaine with 1:100,000 epinephrine buccal infiltration to buccal plus lingual infiltration of the same dose of drug in achieving pulpal anesthesia of mandibular first molar teeth. Data were compared with efficacy of an inferior alveolar nerve block using 2% lidocaine 1:80,000 epinephrine in a cohort of 27 of the volunteers. Anesthesia was determined using electronic pulp testing. Buccal and buccal plus lingual infiltrations of Articaine with epinephrine did not differ in efficacy in obtaining pulpal anesthesia for mandibular permanent first molars (p = 0.17). Efficacy of 4% Articaine with epinephrine infiltrations for first molar pulp anesthesia was similar to that of an IANB using lidocaine with epinephrine over a 30-minute study period (96 and 80 episodes of no response to maximal stimulation respectively, p = 0.097). Subjective tooth numbness was more common after IANB than buccal infiltration (p = 0.005). The discomfort of buccal infiltration with Articaine was volume dependent (p = 0.017) and similar to that of an IANB.
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Articaine and lidocaine mandibular buccal infiltration anesthesia a prospective randomized double blind cross over study
Journal of Endodontics, 2006Co-Authors: Mohammad Dib Kanaa, John Martin Whitworth, I. P. Corbett, John Gerard MeechanAbstract:Abstract This randomized crossover double-blind trial compared the efficacy of buccal infiltration with 4% Articaine and 2% lidocaine (both with 1:100,000 epinephrine) in securing mandibular first molar pulp anesthesia. Injections were given at least 1 week apart in 31 healthy adult volunteers. Electronic pulp testing was undertaken at baseline and at 2 minute intervals until 30 minutes postinjection. A successful outcome was recorded in the absence of pulp sensation on two consecutive maximal pulp tester stimulations (80 μA). 64.5% of Articaine and 38.7% of lidocaine infiltrations were successful (p = 0.008). Articaine infiltration produced significantly more episodes of no response to maximum stimulation in first molars than lidocaine (236 and 129, respectively, p
Joel M Weaver - One of the best experts on this subject based on the ideXlab platform.
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a comparison of Articaine and lidocaine for inferior alveolar nerve blocks
Journal of Endodontics, 2005Co-Authors: Philip Mikesell, Al Reader, John Nusstein, Mike Beck, Joel M WeaverAbstract:The purpose of this prospective, randomized, double-blind study was to compare the degree of pulpal anesthesia obtained with 4% Articaine with 1:100,000 epinephrine and 2% lidocaine with 1:100,000 epinephrine in inferior alveolar nerve blocks. Using a crossover design, inferior alveolar nerve blocks were randomly administered, in a double-blind manner, using 4% Articaine with 1:100,000 epinephrine and 2% lidocaine with 1:100,000 epinephrine, at two separate appointments, to 57 subjects. A pulp tester was used to test for anesthesia, in 4-min cycles for 60 min, of the molars, premolars, central, and lateral incisors. Anesthesia was considered successful when two consecutive 80 readings were obtained within 15 min and the 80 reading was continuously sustained for 60 min. Using the Articaine solution, successful pulpal anesthesia ranged from 4 to 54% from the central incisor to the second molar. Using the lidocaine solution, successful pulpal anesthesia ranged from 2 to 48%. There was no significant difference (p > 0.05) between the Articaine and lidocaine solutions. We concluded that 4% Articaine with 1:100,000 epinephrine was similar to 2% lidocaine with 1:100,000 epinephrine in inferior alveolar nerve blocks.
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efficacy of Articaine and lidocaine in a primary intraligamentary injection administered with a computer controlled local anesthetic delivery system
Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, 2005Co-Authors: Jeffrey Berlin, Al Reader, John Nusstein, Mike Beck, Joel M WeaverAbstract:Objective The purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of the intraligamentary injection of 4% Articaine with 1:100,000 epinephrine and of 2% lidocaine with 1:100,000 epinephrine, administered with computer-controlled local anesthetic delivery system, in mandibular posterior teeth. Study design Using a crossover design, intraligamentary injections of 1.4 mL of 4% Articaine with 1:100,000 epinephrine and of 1.4 mL of 2% lidocaine with 1:100,000 epinephrine were randomly administered with a computer-controlled local anesthetic delivery system, in a double-blind manner on the mesial and distal aspects of a mandibular first molar, at 2 separate appointments to 51 subjects. A pulp tester was used to test for anesthesia, in 2-minute cycles for 60 minutes, of the mandibular first and second molars and second premolar. Anesthesia was considered successful when 2 consecutive 80 readings (highest output) were obtained within 20 minutes. Results Successful pulpal anesthesia was obtained 86% of the time for the first molar using the Articaine solution and 74% of the time using the lidocaine solution. There were no significant differences ( P > .05) between the Articaine and lidocaine solutions. The mean onset times of pulpal anesthesia for the first molar were 1.3 minutes with Articaine solution and 2.2 minutes with lidocaine solution. Duration of pulpal anesthesia for the first molar was 34 minutes for the Articaine solution and 31 minutes for the lidocaine solution. Conclusion The efficacy of 4% Articaine with 1:100,000 epinephrine was similar to the efficacy of 2% lidocaine with 1:100,000 epinephrine for intraligamentary injections.
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anesthetic efficacy of Articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis
Journal of Endodontics, 2004Co-Authors: Elizabeth Claffey, Al Reader, John Nusstein, Mike Beck, Joel M WeaverAbstract:The purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of 4% Articaine with 1:100,000 epinephrine to 2% lidocaine with 1:100,000 epinephrine for inferior alveolar nerve blocks in patients experiencing irreversible pulpitis in mandibular posterior teeth. Seventy-two emergency patients diagnosed with irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, 2.2 ml of 4% Articaine with 1:100,000 epinephrine or 2.2 ml of 2% lidocaine with 1:100,000 epinephrine using a conventional inferior alveolar nerve block. Endodontic access was begun 15 min after solution deposition, and all patients were required to have profound lip numbness. Success was defined as none or mild pain (Visual Analogue Scale recordings) on endodontic access or initial instrumentation. The success rate for the inferior alveolar nerve block using Articaine was 24% and for the lidocaine solution success was 23%. There was no significant difference (p = 0.89) between the Articaine and lidocaine solutions. Neither solution resulted in an acceptable rate of anesthetic success in patients with irreversible pulpitis.
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comparison of injection pain heart rate increase and postinjection pain of Articaine and lidocaine in a primary intraligamentary injection administered with a computer controlled local anesthetic delivery system
Anesthesia Progress, 2004Co-Authors: John Nusstein, Al Reader, Jeffrey Berlin, Michael W Beck, Joel M WeaverAbstract:The purpose of this prospective, randomized, double-blind study was to compare the pain of injection, heart rate increase, and postinjection pain of the intraligamentary injection of 4% Articaine with 1:100,000 epinephrine and 2% lidocaine with 1:100,000 epinephrine administered with a computer-controlled local anesthetic delivery system. Using a crossover design, intraligamentary injections of 1.4 mL of 4% Articaine with 1:100,000 epinephrine and 1.4 mL of 2% lidocaine with 1:100,000 epinephrine were randomly administered on the mesial and distal aspects of the mandibular first molar with a computer-controlled local anesthetic delivery system in a double-blind manner at 2 separate appointments to 51 subjects. The results demonstrated the incidence of moderate pain was 14%-27% with needle insertion, with 0%-4% reporting severe pain. For solution deposition, moderate pain was reported 8%-18% of the time, with no reports of severe pain. There were no significant differences between the Articaine and lidocaine solutions. Regarding heart rate changes, neither anesthetic solution resulted in a significant increase in heart rate over baseline readings. On day 1 postinjection, there was a 31% incidence of moderate/severe pain with the Articaine solution and 20% incidence of moderate/severe pain with the lidocaine solution. The moderate/severe pain ratings decreased over the next 2 days. There were no significant differences between the Articaine and lidocaine solutions. We concluded that the intraligamentary injection of 4% Articaine with 1:100,000 epinephrine was similar to 2% lidocaine with 1:100,000 epinephrine for injection pain and postinjection pain in the mandibular first molar when administered with a computer-controlled local anesthetic delivery system. For both anesthetic solutions, heart rate did not significantly increase with the intraligamentary injection using the computer-controlled local anesthetic system.
