Buffered 4% Articaine as a Primary Buccal Infiltration of the Mandibular First Molar: A Prospective, Randomized, Double-blind Study.

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.

• Authors: Ryan Shurtz, John Nusstein, Al Reader, Melissa Drum, Sara Fowler, Mike Beck
• Journal: Journal of endodontics (J Endod) Vol. 41 Issue 9 Pg. 1403-7 (Sep 2015) ISSN: 1878-3554 [Electronic] United States
• PMID: 26095381 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anesthetics, Local
• Carticaine
• Epinephrine

Topics

• Adult
• Anesthesia, Dental (methods)
• Anesthetics, Local (administration & dosage)
• Carticaine (administration & dosage)
• Cross-Over Studies
• Dental Pulp (drug effects)
• Dental Pulp Test
• Double-Blind Method
• Epinephrine (administration & dosage)
• Female
• Humans
• Male
• Mandible
• Molar (drug effects)
• Prospective Studies
• Young Adult