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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, Melissa Drum, John Nusstein, Al Reader, Sara Fowler, 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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a prospective randomized double blind comparison of the anesthetic efficacy of two percent lidocaine with 1 100 000 epinephrine and three percent mepivacaine in the maxillary high tuberosity second division nerve block
Journal of Endodontics, 2010Co-Authors: Amy Forloine, Melissa Drum, John Nusstein, Al Reader, Mike BeckAbstract:Abstract Introduction The purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of 2% lidocaine with 1:100,000 epinephrine and 3% mepivacaine in the maxillary high tuberosity second division nerve block. Methods Fifty subjects randomly received maxillary high tuberosity second division nerve blocks by using 3.6 mL of 2% lidocaine with 1:100,000 epinephrine and 3.6 mL of 3% mepivacaine at 2 separate appointments spaced at least 1 week apart. The anterior, premolar, and molar teeth were Pulp tested in 4-minute cycles for a total of 60 minutes. Success was defined as no subject response to 2 consecutive 80 readings with the electric Pulp Tester. Results and Conclusions The high tuberosity approach to the maxillary second division nerve block with both anesthetic formulations resulted in a high success rate (92%–98%) for the first and second molars. Approximately 76%–78% of the second premolars were anesthetized with both anesthetic formulations. Both anesthetic formulations were ineffective for the anterior teeth and first premolars. The use of 3% mepivacaine provided a significantly shorter duration of Pulpal anesthesia than 2% lidocaine with 1:100,000 epinephrine in the molars and premolars.
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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, John Nusstein, Al Reader, 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.
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Anesthetic Efficacy of 1.8 mL and 3.6 mL of 2% Lidocaine with 1:100,000 Epinephrine for Maxillary Infiltrations
Journal of Endodontics, 2008Co-Authors: Alan Mikesell, Melissa Drum, Al Reader, Mike BeckAbstract:The purpose of this prospective, randomized, single-blinded study was to measure the degree of anesthesia obtained with 1.8 mL and 3.6 mL of 2% lidocaine with 1:100,000 epinephrine in maxillary infiltrations. Ninety-six adult subjects randomly received infiltrations of 1.8 mL and 3.6 mL of the lidocaine solution at two separate appointments, in a crossover design. Thirty-two lateral incisors, 32 first premolars and 32 first molars were studied in this investigation. Anesthetic success (obtaining two consecutive 80 readings with the electric Pulp Tester) for the two volumes ranged from 97% to 100%. The onset of Pulpal anesthesia was not statistically different between the two volumes. For both volumes, the lateral incisors had a higher percentage of anesthesia of short duration than the first premolar and first molar. The 3.6 mL volume provided a statistically longer duration of Pulpal anesthesia for the lateral incisor, first premolar, and first molar. © 2008 American Association of Endodontists.
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An evaluation of volumes and concentrations of lidocaine in human inferior alveolar nerve block.
Journal of Endodontics, 2007Co-Authors: David L. Vreeland, Mike Beck, Al Reader, William J. Meyers, Joel M WeaverAbstract:The purpose of this study was to evaluate, with the electric Pulp Tester, the anesthetic efficacy of 1.8 ml of 2% lidocaine with 1:100,000 epinephrine, 3.6 ml of 2% lidocaine with 1:200,000 epinephrine, and 1.8 ml of 4% lidocaine with 1:100,000 epinephrine in human inferior alveolar nerve block. Thirty subjects randomly received each of the solutions at three successive appointments. The first molar, canine, lateral incisor, and contralateral canine were tested with the Pulp Tester at various time intervals up to 55 min. Complete anesthesia was defined as an 80/80 reading with the Pulp Tester. No significant differences in anesthetic success or failure were found among the three solutions. Potential anesthetic problems (failure, noncontinuous anesthesia, slow onset, and short duration) occurred in 43 to 57% of the molars, in 43 to 60% of the canines, and in 57 to 80% of the lateral incisors. Complete anesthesia in the mandible is a meaningful clinical problem.
John Gerard Meechan - One of the best experts on this subject based on the ideXlab platform.
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Effect of Massage on the Efficacy of the Mental and Incisive Nerve Block
Anesthesia Progress, 2013Co-Authors: A. Jaber, I. P. Corbett, John Whitworth, B. Al-baqshi, S. Jauhar, John Gerard MeechanAbstract:The purpose of this trial was to assess the effect of soft tissue massage on the efficacy of the mental and incisive nerve block (MINB). Thirty-eight volunteers received MINB of 2.2 mL of 2% lidocaine with 1 : 80,000 epinephrine on 2 occasions. At one visit the soft tissue overlying the injection site was massaged for 60 seconds (active treatment). At the other visit the crowns of the mandibular premolar teeth were massaged (control treatment). Order of treatments was randomized. An electronic Pulp Tester was used to measure Pulpal anesthesia in the ipsilateral mandibular first molar, a premolar, and lateral incisor teeth up to 45 minutes following the injection. The efficacy of Pulp anesthesia was determined by 2 methods: (a) by quantifying the number of episodes with no response to maximal electronic Pulp stimulation after each treatment, and (b) by quantifying the number of volunteers with no response to maximal Pulp stimulation (80 reading) on 2 or more consecutive tests, termed anesthetic success. Data were analyzed by McNemar, Mann-Whitney, and paired-samples t tests. Anesthetic success was 52.6% for active and 42.1% for control treatment for lateral incisors, 89.5 and 86.8% respectively for premolars, and 50.0 and 42.1% respectively for first molars (P = .344, 1.0, and .508 respectively). There were no significant differences in the number of episodes of negative response to maximum Pulp Tester stimulation between active and control massage. A total of 131 episodes were recorded after both active and control massage in lateral incisors (McNemar test, P = 1.0), 329 (active) versus 316 (control) episodes in the premolars (McNemar test, P = .344), and 119 (active) versus 109 (control) episodes respectively for first molars (McNemar test, P = .444). Speed of anesthetic onset and discomfort did not differ between treatments. We concluded that soft tissue massage after MINB does not influence anesthetic efficacy.
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Buccal versus lingual articaine infiltration for mandibular tooth anaesthesia: a randomized controlled trial
International Endodontic Journal, 2011Co-Authors: John Gerard Meechan, A. Jaber, I. P. Corbett, John WhitworthAbstract:Meechan JG, Jaber AA, Corbett IP, Whitworth JM. Buccal versus lingual articaine infiltration for mandibular tooth anaesthesia: a randomized controlled trial. International Endodontic Journal, 44, 676–681, 2011. Abstract Aim To compare the effectiveness of buccal and lingual local anaesthetic injections in the mandibular first molar region in obtaining Pulpal anaesthesia in mandibular teeth. Methodology Twenty healthy volunteers received 1.8 mL of 4% articaine with 1 : 100 000 epinephrine as a buccal or lingual infiltration in the mandibular first molar region in a randomized double-blind cross-over design. The responses of the first molar, a premolar and the lateral incisor teeth were assessed using an electronic Pulp Tester over a 47-min period. Successful anaesthesia was defined as no response to maximum stimulus from the Pulp Tester on two or more consecutive tests. Success between techniques was analysed using the McNemar test and variations between teeth were compared with Chi-square. Results The number of no responses to maximum stimulation from an electronic Pulp Tester was significantly greater for all test teeth after the buccal injection compared with the lingual approach (P
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The efficacy of infiltration anaesthesia for adult mandibular incisors: a randomised double-blind cross-over trial comparing articaine and lidocaine buccal and buccal plus lingual infiltrations
British Dental Journal, 2010Co-Authors: A. Jaber, John Martin Whitworth, Mohammad Dib Kanaa, I. P. Corbett, B. Al-baqshi, John Gerard MeechanAbstract:Aim To compare the efficacy of 2% lidocaine and 4% articaine both with 1:100,000 adrenaline in anaesthetising the Pulps of mandibular incisors. Methods Thirty-one healthy adult volunteers received the following local anaesthetic regimens adjacent to a mandibular central incisor: 1) buccal infiltration of 1.8 mL lidocaine plus dummy lingual injection (LB), 2) buccal plus lingual infiltrations of 0.9 mL lidocaine (LBL), 3) buccal infiltration of 1.8 mL articaine plus dummy lingual injection (AB), 4) buccal plus lingual infiltrations of 0.9 mL articaine (ABL). Pulp sensitivities of the central incisor and contralateral lateral incisor were assessed electronically. Anaesthetic efficacy was determined by two methods: 1) Recording the number of episodes with no responses to maximal electronic Pulp Tester stimulation during the course of the study period, 2) recording the number of volunteers with no response to maximal Pulp Tester stimulation within 15 min and maintained for 45 min (defined as sustained anaesthesia). Data were analysed by McNemar, chi-square, Mann-Whitney and paired t–tests. Results For both test teeth, the number of episodes of no sensation on maximal stimulation was significantly greater after articaine than lidocaine for both techniques. The split buccal plus lingual dose was more effective than the buccal injection alone for both solutions (p
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The efficacy of infiltration anaesthesia for adult mandibular incisors: a randomised double-blind cross-over trial comparing articaine and lidocaine buccal and buccal plus lingual infiltrations
British Dental Journal, 2010Co-Authors: A. Jaber, John Martin Whitworth, Mohammad Dib Kanaa, I. P. Corbett, B. Al-baqshi, John Gerard MeechanAbstract:Infiltration injections are effective in the mandibular incisor region. The combination of buccal and lingual infiltrations seems to offer the best anaesthetic profile. 4% articaine with adrenaline is more effective than 2% lidocaine with adrenaline as an infiltration anaesthetic in the mandibular incisor region. Aim To compare the efficacy of 2% lidocaine and 4% articaine both with 1:100,000 adrenaline in anaesthetising the Pulps of mandibular incisors. Methods Thirty-one healthy adult volunteers received the following local anaesthetic regimens adjacent to a mandibular central incisor: 1) buccal infiltration of 1.8 mL lidocaine plus dummy lingual injection (LB), 2) buccal plus lingual infiltrations of 0.9 mL lidocaine (LBL), 3) buccal infiltration of 1.8 mL articaine plus dummy lingual injection (AB), 4) buccal plus lingual infiltrations of 0.9 mL articaine (ABL). Pulp sensitivities of the central incisor and contralateral lateral incisor were assessed electronically. Anaesthetic efficacy was determined by two methods: 1) Recording the number of episodes with no responses to maximal electronic Pulp Tester stimulation during the course of the study period, 2) recording the number of volunteers with no response to maximal Pulp Tester stimulation within 15 min and maintained for 45 min (defined as sustained anaesthesia). Data were analysed by McNemar, chi-square, Mann-Whitney and paired t–tests. Results For both test teeth, the number of episodes of no sensation on maximal stimulation was significantly greater after articaine than lidocaine for both techniques. The split buccal plus lingual dose was more effective than the buccal injection alone for both solutions (p
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The efficacy of infiltration anaesthesia for adult mandibular incisors: a randomised double-blind cross-over trial comparing articaine and lidocaine buccal and buccal plus lingual infiltrations.
British Dental Journal, 2010Co-Authors: A. Jaber, Mohammad Dib Kanaa, I. P. Corbett, John Whitworth, B. Al-baqshi, John Gerard MeechanAbstract:AIM: To compare the efficacy of 2% lidocaine and 4% articaine both with 1:100,000 adrenaline in anaesthetising the Pulps of mandibular incisors. METHODS: Thirty-one healthy adult volunteers received the following local anaesthetic regimens adjacent to a mandibular central incisor: 1) buccal infiltration of 1.8 mL lidocaine plus dummy lingual injection (LB), 2) buccal plus lingual infiltrations of 0.9 mL lidocaine (LBL), 3) buccal infiltration of 1.8 mL articaine plus dummy lingual injection (AB), 4) buccal plus lingual infiltrations of 0.9 mL articaine (ABL). Pulp sensitivities of the central incisor and contralateral lateral incisor were assessed electronically. Anaesthetic efficacy was determined by two methods: 1) Recording the number of episodes with no responses to maximal electronic Pulp Tester stimulation during the course of the study period, 2) recording the number of volunteers with no response to maximal Pulp Tester stimulation within 15 min and maintained for 45 min (defined as sustained anaesthesia). Data were analysed by McNemar, chi-square, Mann-Whitney and paired t-tests. RESULTS: For both test teeth, the number of episodes of no sensation on maximal stimulation was significantly greater after articaine than lidocaine for both techniques. The split buccal plus lingual dose was more effective than the buccal injection alone for both solutions (p
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, Melissa Drum, John Nusstein, Al Reader, Sara Fowler, 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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a prospective randomized double blind comparison of 2 mepivacaine with 1 20 000 levonordefrin versus 2 lidocaine with 1 100 000 epinephrine for maxillary infiltrations
Anesthesia Progress, 2010Co-Authors: Ingrid Lawaty, Melissa Drum, Al Reader, John NussteinAbstract:The purpose of this prospective, randomized, double-blind crossover study was to compare the anesthetic efficacy of 2% mepivacaine with 1 : 20,000 levonordefrin versus 2% lidocaine with 1 : 100,000 epinephrine in maxillary central incisors and first molars. Sixty subjects randomly received, in a double-blind manner, maxillary central incisor and first molar infiltrations of 1.8 mL of 2% mepivacaine with 1 : 20,000 levonordefrin and 1.8 mL of 2% lidocaine with 1 : 100,000 epinephrine at 2 separate appointments spaced at least 1 week apart. The teeth were electric Pulp tested in 2-minute cycles for a total of 60 minutes. Anesthetic success (obtaining 2 consecutive 80 readings with the electric Pulp Tester within 10 minutes) was not significantly different between 2% mepivacaine with 1 : 20,000 levonordefrin and 2% lidocaine with 1 : 100,000 epinephrine for the central incisor and first molar. However, neither anesthetic agent provided an hour of Pulpal anesthesia.
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a prospective randomized double blind comparison of the anesthetic efficacy of two percent lidocaine with 1 100 000 epinephrine and three percent mepivacaine in the maxillary high tuberosity second division nerve block
Journal of Endodontics, 2010Co-Authors: Amy Forloine, Melissa Drum, John Nusstein, Al Reader, Mike BeckAbstract:Abstract Introduction The purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of 2% lidocaine with 1:100,000 epinephrine and 3% mepivacaine in the maxillary high tuberosity second division nerve block. Methods Fifty subjects randomly received maxillary high tuberosity second division nerve blocks by using 3.6 mL of 2% lidocaine with 1:100,000 epinephrine and 3.6 mL of 3% mepivacaine at 2 separate appointments spaced at least 1 week apart. The anterior, premolar, and molar teeth were Pulp tested in 4-minute cycles for a total of 60 minutes. Success was defined as no subject response to 2 consecutive 80 readings with the electric Pulp Tester. Results and Conclusions The high tuberosity approach to the maxillary second division nerve block with both anesthetic formulations resulted in a high success rate (92%–98%) for the first and second molars. Approximately 76%–78% of the second premolars were anesthetized with both anesthetic formulations. Both anesthetic formulations were ineffective for the anterior teeth and first premolars. The use of 3% mepivacaine provided a significantly shorter duration of Pulpal anesthesia than 2% lidocaine with 1:100,000 epinephrine in the molars and premolars.
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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, John Nusstein, Al Reader, 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.
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A comparison of the local anesthetic efficacy of the extraoral versus the intraoral infraorbital nerve block
Journal of the American Dental Association, 2010Co-Authors: Bradley Karkut, Melissa Drum, John Nusstein, Al Reader, Michael W BeckAbstract:ABSTRACT Background The efficacy of the extraoral infraorbital nerve block has not been studied sufficiently to ensure its appropriate clinical use. To compare the local anesthetic efficacy of the extraoral versus the intraoral infraorbital nerve block, the authors conducted a prospective, randomized crossover study. Methods Forty adult participants randomly received extraoral infraorbital nerve blocks of 1.8 milliliters of 2 percent lidocaine with 1:100,000 epinephrine at one appointment and intraoral infraorbital nerve blocks of 1.8 mL of 2 percent lidocaine with 1:100,000 epinephrine at another appointment in a crossover design. After administering the injections, the authors used an electric Pulp Tester to assess the maxillary central and lateral incisors, canine, premolars and first molar for Pulpal anesthesia in four-minute cycles for 60 minutes. They considered anesthesia to be successful when the participant had no response to two consecutive 80 readings (the maximum output) with the electric Pulp Tester. Conclusions The authors found that the extraoral and intraoral infraorbital nerve blocks were ineffective in providing profound Pulpal anesthesia of the maxillary central incisor (15 percent success rate) and lateral incisor (22 percent success rate). The Pulpal anesthesia success rate was 92 percent for the canine for both types of nerve blocks, 80 to 90 percent for first and second premolars and 65 to 70 percent for the first molar, with no significant differences ( P Clinical Implications Both nerve blocks would be ineffective in the central and lateral incisors. Both nerve blocks would be somewhat successful in the canine and premolars but not in the 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, Melissa Drum, John Nusstein, Al Reader, Sara Fowler, 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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a prospective randomized double blind comparison of 2 mepivacaine with 1 20 000 levonordefrin versus 2 lidocaine with 1 100 000 epinephrine for maxillary infiltrations
Anesthesia Progress, 2010Co-Authors: Ingrid Lawaty, Melissa Drum, Al Reader, John NussteinAbstract:The purpose of this prospective, randomized, double-blind crossover study was to compare the anesthetic efficacy of 2% mepivacaine with 1 : 20,000 levonordefrin versus 2% lidocaine with 1 : 100,000 epinephrine in maxillary central incisors and first molars. Sixty subjects randomly received, in a double-blind manner, maxillary central incisor and first molar infiltrations of 1.8 mL of 2% mepivacaine with 1 : 20,000 levonordefrin and 1.8 mL of 2% lidocaine with 1 : 100,000 epinephrine at 2 separate appointments spaced at least 1 week apart. The teeth were electric Pulp tested in 2-minute cycles for a total of 60 minutes. Anesthetic success (obtaining 2 consecutive 80 readings with the electric Pulp Tester within 10 minutes) was not significantly different between 2% mepivacaine with 1 : 20,000 levonordefrin and 2% lidocaine with 1 : 100,000 epinephrine for the central incisor and first molar. However, neither anesthetic agent provided an hour of Pulpal anesthesia.
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a prospective randomized double blind comparison of the anesthetic efficacy of two percent lidocaine with 1 100 000 epinephrine and three percent mepivacaine in the maxillary high tuberosity second division nerve block
Journal of Endodontics, 2010Co-Authors: Amy Forloine, Melissa Drum, John Nusstein, Al Reader, Mike BeckAbstract:Abstract Introduction The purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of 2% lidocaine with 1:100,000 epinephrine and 3% mepivacaine in the maxillary high tuberosity second division nerve block. Methods Fifty subjects randomly received maxillary high tuberosity second division nerve blocks by using 3.6 mL of 2% lidocaine with 1:100,000 epinephrine and 3.6 mL of 3% mepivacaine at 2 separate appointments spaced at least 1 week apart. The anterior, premolar, and molar teeth were Pulp tested in 4-minute cycles for a total of 60 minutes. Success was defined as no subject response to 2 consecutive 80 readings with the electric Pulp Tester. Results and Conclusions The high tuberosity approach to the maxillary second division nerve block with both anesthetic formulations resulted in a high success rate (92%–98%) for the first and second molars. Approximately 76%–78% of the second premolars were anesthetized with both anesthetic formulations. Both anesthetic formulations were ineffective for the anterior teeth and first premolars. The use of 3% mepivacaine provided a significantly shorter duration of Pulpal anesthesia than 2% lidocaine with 1:100,000 epinephrine in the molars and premolars.
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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, John Nusstein, Al Reader, 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.
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A comparison of the local anesthetic efficacy of the extraoral versus the intraoral infraorbital nerve block
Journal of the American Dental Association, 2010Co-Authors: Bradley Karkut, Melissa Drum, John Nusstein, Al Reader, Michael W BeckAbstract:ABSTRACT Background The efficacy of the extraoral infraorbital nerve block has not been studied sufficiently to ensure its appropriate clinical use. To compare the local anesthetic efficacy of the extraoral versus the intraoral infraorbital nerve block, the authors conducted a prospective, randomized crossover study. Methods Forty adult participants randomly received extraoral infraorbital nerve blocks of 1.8 milliliters of 2 percent lidocaine with 1:100,000 epinephrine at one appointment and intraoral infraorbital nerve blocks of 1.8 mL of 2 percent lidocaine with 1:100,000 epinephrine at another appointment in a crossover design. After administering the injections, the authors used an electric Pulp Tester to assess the maxillary central and lateral incisors, canine, premolars and first molar for Pulpal anesthesia in four-minute cycles for 60 minutes. They considered anesthesia to be successful when the participant had no response to two consecutive 80 readings (the maximum output) with the electric Pulp Tester. Conclusions The authors found that the extraoral and intraoral infraorbital nerve blocks were ineffective in providing profound Pulpal anesthesia of the maxillary central incisor (15 percent success rate) and lateral incisor (22 percent success rate). The Pulpal anesthesia success rate was 92 percent for the canine for both types of nerve blocks, 80 to 90 percent for first and second premolars and 65 to 70 percent for the first molar, with no significant differences ( P Clinical Implications Both nerve blocks would be ineffective in the central and lateral incisors. Both nerve blocks would be somewhat successful in the canine and premolars but not in the first molar.
Mohammad Dib Kanaa - One of the best experts on this subject based on the ideXlab platform.
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The efficacy of infiltration anaesthesia for adult mandibular incisors: a randomised double-blind cross-over trial comparing articaine and lidocaine buccal and buccal plus lingual infiltrations
British Dental Journal, 2010Co-Authors: A. Jaber, John Martin Whitworth, Mohammad Dib Kanaa, I. P. Corbett, B. Al-baqshi, John Gerard MeechanAbstract:Aim To compare the efficacy of 2% lidocaine and 4% articaine both with 1:100,000 adrenaline in anaesthetising the Pulps of mandibular incisors. Methods Thirty-one healthy adult volunteers received the following local anaesthetic regimens adjacent to a mandibular central incisor: 1) buccal infiltration of 1.8 mL lidocaine plus dummy lingual injection (LB), 2) buccal plus lingual infiltrations of 0.9 mL lidocaine (LBL), 3) buccal infiltration of 1.8 mL articaine plus dummy lingual injection (AB), 4) buccal plus lingual infiltrations of 0.9 mL articaine (ABL). Pulp sensitivities of the central incisor and contralateral lateral incisor were assessed electronically. Anaesthetic efficacy was determined by two methods: 1) Recording the number of episodes with no responses to maximal electronic Pulp Tester stimulation during the course of the study period, 2) recording the number of volunteers with no response to maximal Pulp Tester stimulation within 15 min and maintained for 45 min (defined as sustained anaesthesia). Data were analysed by McNemar, chi-square, Mann-Whitney and paired t–tests. Results For both test teeth, the number of episodes of no sensation on maximal stimulation was significantly greater after articaine than lidocaine for both techniques. The split buccal plus lingual dose was more effective than the buccal injection alone for both solutions (p
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The efficacy of infiltration anaesthesia for adult mandibular incisors: a randomised double-blind cross-over trial comparing articaine and lidocaine buccal and buccal plus lingual infiltrations
British Dental Journal, 2010Co-Authors: A. Jaber, John Martin Whitworth, Mohammad Dib Kanaa, I. P. Corbett, B. Al-baqshi, John Gerard MeechanAbstract:Infiltration injections are effective in the mandibular incisor region. The combination of buccal and lingual infiltrations seems to offer the best anaesthetic profile. 4% articaine with adrenaline is more effective than 2% lidocaine with adrenaline as an infiltration anaesthetic in the mandibular incisor region. Aim To compare the efficacy of 2% lidocaine and 4% articaine both with 1:100,000 adrenaline in anaesthetising the Pulps of mandibular incisors. Methods Thirty-one healthy adult volunteers received the following local anaesthetic regimens adjacent to a mandibular central incisor: 1) buccal infiltration of 1.8 mL lidocaine plus dummy lingual injection (LB), 2) buccal plus lingual infiltrations of 0.9 mL lidocaine (LBL), 3) buccal infiltration of 1.8 mL articaine plus dummy lingual injection (AB), 4) buccal plus lingual infiltrations of 0.9 mL articaine (ABL). Pulp sensitivities of the central incisor and contralateral lateral incisor were assessed electronically. Anaesthetic efficacy was determined by two methods: 1) Recording the number of episodes with no responses to maximal electronic Pulp Tester stimulation during the course of the study period, 2) recording the number of volunteers with no response to maximal Pulp Tester stimulation within 15 min and maintained for 45 min (defined as sustained anaesthesia). Data were analysed by McNemar, chi-square, Mann-Whitney and paired t–tests. Results For both test teeth, the number of episodes of no sensation on maximal stimulation was significantly greater after articaine than lidocaine for both techniques. The split buccal plus lingual dose was more effective than the buccal injection alone for both solutions (p
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The efficacy of infiltration anaesthesia for adult mandibular incisors: a randomised double-blind cross-over trial comparing articaine and lidocaine buccal and buccal plus lingual infiltrations.
British Dental Journal, 2010Co-Authors: A. Jaber, Mohammad Dib Kanaa, I. P. Corbett, John Whitworth, B. Al-baqshi, John Gerard MeechanAbstract:AIM: To compare the efficacy of 2% lidocaine and 4% articaine both with 1:100,000 adrenaline in anaesthetising the Pulps of mandibular incisors. METHODS: Thirty-one healthy adult volunteers received the following local anaesthetic regimens adjacent to a mandibular central incisor: 1) buccal infiltration of 1.8 mL lidocaine plus dummy lingual injection (LB), 2) buccal plus lingual infiltrations of 0.9 mL lidocaine (LBL), 3) buccal infiltration of 1.8 mL articaine plus dummy lingual injection (AB), 4) buccal plus lingual infiltrations of 0.9 mL articaine (ABL). Pulp sensitivities of the central incisor and contralateral lateral incisor were assessed electronically. Anaesthetic efficacy was determined by two methods: 1) Recording the number of episodes with no responses to maximal electronic Pulp Tester stimulation during the course of the study period, 2) recording the number of volunteers with no response to maximal Pulp Tester stimulation within 15 min and maintained for 45 min (defined as sustained anaesthesia). Data were analysed by McNemar, chi-square, Mann-Whitney and paired t-tests. RESULTS: For both test teeth, the number of episodes of no sensation on maximal stimulation was significantly greater after articaine than lidocaine for both techniques. The split buccal plus lingual dose was more effective than the buccal injection alone for both solutions (p
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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, John 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
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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
