Oral and maxillofacial surgeryA comparison of the clinical anesthetic efficacy of 4% articaine and 0.5% bupivacaine (both with 1:200,000 epinephrine) for lower third molar removal
Section snippets
Material and Methods
The institutional Ethics Committee approved the protocol and the informed consent document of this study (#75/2006). All patients provided written informed consent during the pretreatment screening period before any study procedures were performed.
The study population comprised 50 patients aged 18 years or over, with both lower third molars in similar positions, as observed in panoramic radiographies. All the subjects were in good health, and none was taking any medication that would alter pain
Results
The study comprised 50 healthy volunteers (21 males and 29 females), with a mean age of 21.84 ± 0.65 years (range 18 to 35), who were divided into 2 categories: surgeries requiring osteotomy (28 patients), and surgeries not requiring osteotomy (22 patients). Hence, all the results except time to onset are expressed according to these 2 categories.
A statistically significant difference between the time to onset of A200 (1.66 ± 0.13 minutes) and B200 (2.51 ± 0.21 minutes) was found (P < .05).
The
Discussion
The present study compares the clinical properties of 2 local anesthetics, 4% articaine (A200) and 0.5% bupivacaine (B200), both with 1:200,000 epinephrine. Our results suggest that A200 may be a more desirable local anesthetic to use in some patients compared with B200 because of its shorter time to onset, its shorter duration of soft tissue anesthesia, and comparable intraoperative bleeding control and postoperative analgesic effects as well as possibly somewhat better pain control during the
Conclusion
In comparison with 0.5% bupivacaine, 4% articaine (both with 1:200,000 epinephrine) provided a shorter time to onset, and comparable hemostasis and postoperative pain control, with a shorter duration of soft tissue anesthesia in lower third molar removal. Fewer patients required supplemental intraoperative injections when operated with 4% articaine.
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2023, Journal of the American Dental AssociationComparative study of the anaesthetic efficacy of 4% articaine versus 2% lidocaine with adrenaline during extraction of mandibular molars using an inferior alveolar nerve blocking technique
2021, British Journal of Oral and Maxillofacial SurgeryCitation Excerpt :Profoundness of anaesthesia was measured in a visual analogue scale (VAS) of 1-10, in which the patient was instructed to score the intensity of pain intraoperatively. Rebolledo et al2 and Gregorio et al15 also noted that the level of intraoperative analgesia evoked by articaine may be explained by its ability to readily diffuse through tissues due to the presence of the thiophene group in the molecule, which increases liposolubility. We experienced neither local nor systemic complications.
Does the Use of Articaine Increase the Risk of Hypesthesia in Lower Third Molar Surgery? A Systematic Review and Meta-Analysis
2021, Journal of Oral and Maxillofacial SurgeryCitation Excerpt :Future studies involving both options should be developed to better clarify the relationship between vasoconstrictor concentration and risk of hypesthesia. Most of the studies were considered to be at low risk of bias,12-19,21,23,24 and although all included studies were randomized, only a few described the randomization method used.13,16,17,20 In addition, most studies12,13,15-20,23,24 performed blinding, with only 118 describing the method used.
Safety and efficacy of 4% articaine in mandibular third-molar extraction: A systematic review and meta-analysis of randomized clinical trials
2020, Journal of the American Dental Association
L.V.L.G. was a recipient of a CNPq fellowship (process #113395/2006-0). The authors thank Vera Lúcia Rufino Rosa for her excellent secretarial assistance. They also thank Dixtal Biomédica Ind e Com Ltda (Marília/SP, Brazil) for kindly providing the DX2010 monitoring system.