TY - JOUR
T1 - Anesthetic efficacy of the intraosseous injection of 2% lidocaine (1:100,000 epinephrine) and 3% mepivacaine in mandibular first molars
AU - Replogle, Karan
AU - Reader, Al
AU - Nist, Robert
AU - Beck, Mike
AU - Weaver, Joel
AU - Meyers, William J.
N1 - Funding Information:
The intraosseous (IO) injection allows placement of a local anesthetic solution directly into the cancellous bone adjacent to the tooth to be anesthetized. Historically, various methods of accessing the cancellous Study was supported by Graduate Endodontic Research Fund. aFormer Graduate Student in Endodontics. bProfessor and Program Director, Division of Endodontics. °Associate Clinical Professor, Division of Endodontics. aAssociate Professor, Department of Health Services Research. eAssociate Professor, Department of Oral and Maxillofacial Surgery. fFormer Chairman and Professor, Department of Endodontics/Diagnostic Services. Submitted for publication May 10, 1996; returned for revision JulY 16, 1996; accepted for publication Aug. 27, 1996. Copyright © 1997 by Mosby-Year Book, Inc. 1079-2104/97/$5.00 + 0 7/15/77717
PY - 1997
Y1 - 1997
N2 - Objectives. This study compared the anesthetic efficacy of a primary intraosseous injection of 2% lidocaine with 1:100,000 epinephrine and 3% mepivacaine in human mandibular first molars. Injection pain and healing postoperatively were also assessed for the intraosseous injection. Study design. With the use of a repeated-measures design, 42 subjects randomly received intraosseous injections of 1.8 ml of 2% lidocaine with 1:100,000 epinephrine or 1.8 ml of 3% mepivacaine in a double-blind manner at two successive appointments. The first molar and adjacent teeth were blindly tested with an electric pulp tester at 2-minute cycles for 60 minutes. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading) for two consecutive readings. Results. Anesthetic success occurred in 74% of the first molars with 2% lidocaine with 1:100,000 epinephrine and in 45% with 3% mepivacaine. The difference was statistically significant (p < 0.05). Overall, onset was rapid for the intraosseous injections, the duration of pulpal anesthesia steadily declined over the 60 minutes, the majority of the subjects had no pain or mild pain with perforation and solution deposition, and 5% of the subjects had delayed healing at the perforation sites. Conclusions. The results of this study indicate that the primary intraosseous injection of 2% lidocaine with 1:100,000 epinephrine is more successful and results in a longer duration of pulpal anesthesia as compared with 3% mepivacaine in noninflamed mandibular first molars. Most subjects reported no or mild pain during perforation and injection.
AB - Objectives. This study compared the anesthetic efficacy of a primary intraosseous injection of 2% lidocaine with 1:100,000 epinephrine and 3% mepivacaine in human mandibular first molars. Injection pain and healing postoperatively were also assessed for the intraosseous injection. Study design. With the use of a repeated-measures design, 42 subjects randomly received intraosseous injections of 1.8 ml of 2% lidocaine with 1:100,000 epinephrine or 1.8 ml of 3% mepivacaine in a double-blind manner at two successive appointments. The first molar and adjacent teeth were blindly tested with an electric pulp tester at 2-minute cycles for 60 minutes. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading) for two consecutive readings. Results. Anesthetic success occurred in 74% of the first molars with 2% lidocaine with 1:100,000 epinephrine and in 45% with 3% mepivacaine. The difference was statistically significant (p < 0.05). Overall, onset was rapid for the intraosseous injections, the duration of pulpal anesthesia steadily declined over the 60 minutes, the majority of the subjects had no pain or mild pain with perforation and solution deposition, and 5% of the subjects had delayed healing at the perforation sites. Conclusions. The results of this study indicate that the primary intraosseous injection of 2% lidocaine with 1:100,000 epinephrine is more successful and results in a longer duration of pulpal anesthesia as compared with 3% mepivacaine in noninflamed mandibular first molars. Most subjects reported no or mild pain during perforation and injection.
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U2 - 10.1016/S1079-2104(97)90087-1
DO - 10.1016/S1079-2104(97)90087-1
M3 - Article
C2 - 9007920
AN - SCOPUS:0030636902
SN - 1079-2104
VL - 83
SP - 30
EP - 37
JO - Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics
JF - Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics
IS - 1
ER -