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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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the efficacy of a repeated buccal infiltration of articaine in prolonging duration of pulpal anesthesia in the mandibular First Molar
Anesthesia Progress, 2009Co-Authors: Lindsay Pabst, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Previous studies have shown declining rates of pulpal anesthesia over 60 minutes when a cartridge of 4% articaine is used with 1∶100,000 epinephrine for buccal infiltration in the mandibular First Molar. The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 2 sets of mandibular First Molar buccal infiltrations, given in 2 separate appointments, to 86 adult subjects: an initial infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine plus a repeated infiltration of the same anesthetic and dose given 25 minutes following the initial infiltration versus an initial infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine plus a mock repeated infiltration given 25 minutes following the initial infiltration. The authors used an electric pulp tester to test the First Molar for anesthesia in 3-minute cycles for 112 minutes after the injections. The repeated infiltration significantly improved pulpal anesthesia from 28 minutes through 109 minutes in the mandibular First Molar. A repeated infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine given 25 minutes after an initial infiltration of the same type and dose of anesthetic significantly improved the duration of pulpal anesthesia, when compared with only an initial buccal infiltration, in the mandibular First Molar.
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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the efficacy of a repeated buccal infiltration of articaine in prolonging duration of pulpal anesthesia in the mandibular First Molar
Anesthesia Progress, 2009Co-Authors: Lindsay Pabst, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Previous studies have shown declining rates of pulpal anesthesia over 60 minutes when a cartridge of 4% articaine is used with 1∶100,000 epinephrine for buccal infiltration in the mandibular First Molar. The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 2 sets of mandibular First Molar buccal infiltrations, given in 2 separate appointments, to 86 adult subjects: an initial infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine plus a repeated infiltration of the same anesthetic and dose given 25 minutes following the initial infiltration versus an initial infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine plus a mock repeated infiltration given 25 minutes following the initial infiltration. The authors used an electric pulp tester to test the First Molar for anesthesia in 3-minute cycles for 112 minutes after the injections. The repeated infiltration significantly improved pulpal anesthesia from 28 minutes through 109 minutes in the mandibular First Molar. A repeated infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine given 25 minutes after an initial infiltration of the same type and dose of anesthetic significantly improved the duration of pulpal anesthesia, when compared with only an initial buccal infiltration, in the mandibular First Molar.
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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the efficacy of a repeated buccal infiltration of articaine in prolonging duration of pulpal anesthesia in the mandibular First Molar
Anesthesia Progress, 2009Co-Authors: Lindsay Pabst, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Previous studies have shown declining rates of pulpal anesthesia over 60 minutes when a cartridge of 4% articaine is used with 1∶100,000 epinephrine for buccal infiltration in the mandibular First Molar. The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 2 sets of mandibular First Molar buccal infiltrations, given in 2 separate appointments, to 86 adult subjects: an initial infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine plus a repeated infiltration of the same anesthetic and dose given 25 minutes following the initial infiltration versus an initial infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine plus a mock repeated infiltration given 25 minutes following the initial infiltration. The authors used an electric pulp tester to test the First Molar for anesthesia in 3-minute cycles for 112 minutes after the injections. The repeated infiltration significantly improved pulpal anesthesia from 28 minutes through 109 minutes in the mandibular First Molar. A repeated infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine given 25 minutes after an initial infiltration of the same type and dose of anesthetic significantly improved the duration of pulpal anesthesia, when compared with only an initial buccal infiltration, in the mandibular First Molar.
Melissa Drum - 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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the efficacy of a repeated buccal infiltration of articaine in prolonging duration of pulpal anesthesia in the mandibular First Molar
Anesthesia Progress, 2009Co-Authors: Lindsay Pabst, Melissa Drum, Al Reader, John Nusstein, Mike BeckAbstract:Previous studies have shown declining rates of pulpal anesthesia over 60 minutes when a cartridge of 4% articaine is used with 1∶100,000 epinephrine for buccal infiltration in the mandibular First Molar. The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 2 sets of mandibular First Molar buccal infiltrations, given in 2 separate appointments, to 86 adult subjects: an initial infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine plus a repeated infiltration of the same anesthetic and dose given 25 minutes following the initial infiltration versus an initial infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine plus a mock repeated infiltration given 25 minutes following the initial infiltration. The authors used an electric pulp tester to test the First Molar for anesthesia in 3-minute cycles for 112 minutes after the injections. The repeated infiltration significantly improved pulpal anesthesia from 28 minutes through 109 minutes in the mandibular First Molar. A repeated infiltration of a cartridge of 4% articaine with 1∶100,000 epinephrine given 25 minutes after an initial infiltration of the same type and dose of anesthetic significantly improved the duration of pulpal anesthesia, when compared with only an initial buccal infiltration, in the mandibular First Molar.
Brett Nydegger - One of the best experts on this subject based on the ideXlab platform.
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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.