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The effect of single buccal infiltration anesthesia of 4% articaine with either 1:100,000 or 1:200,000 epinephrine on pulpal blood flow and anesthesia of maxillary first molars and second premolars in humans

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Abstract

Objectives

The aim of this study was to determine the effect of single buccal infiltration of 4% articaine with either 1:100,000 (EP100) or 1:200,000 (EP200) epinephrine on pulpal blood flow (PBF), pulpal anesthesia and soft tissue anesthesia of maxillary first molars and second premolars in human subjects.

Materials and methods

Fifteen healthy volunteers with intact maxillary first molars and second premolars received an infiltration of 4% articaine with either EP100 or EP200 at buccal aspect of maxillary first molars. The PBF, pulpal anesthesia and soft tissue anesthesia were assessed with a laser Doppler flowmeter (LDF), an electric pulp tester (EPT) and Aesthesiometer II, respectively.

Results

Articaine (4%) with either EP100 or EP200 produced PBF reduction in maxillary first molars (injected teeth) by 68.09 and 69.83%, and produced PBF reduction in second premolars (adjacent teeth) by 76.81 and 75.02%, respectively at 15 min post injection. Duration of PBF returned to baseline was 159.00 ± 21.06 (EP100) and 159.00 ± 31.97 (EP200) min in the molars, and 161.00 ± 20.02 (EP100) and 159.00 ± 25.86 (EP200) min in the premolars. The onset of pulpal anesthesia was 2.80 ± 1.26 (EP100) and 3.07 ± 1.28 (EP200) min in the molars, and 2.13 ± 0.52 (EP100) and 2.40 ± 0.83 (EP200) min in the premolars; the duration of pulpal anesthesia was 74.53 ± 24.16 (EP100) and 76.27 ± 34.03 (EP200) min in the molars, and 82.53 ± 31.03 (EP100) and 75.60 ± 37.17 (EP200) min in the premolars. Buccal tissue anesthesia was found in both teeth (100%), but palatal anesthesia was achieved by 13.33% in the premolars and 6.67% in the molars for each solution.

Conclusions

Single buccal infiltration to maxillary first molar produced PBF reduction and successful pulpal anesthesia, evaluated by EPT, in both first molar and second premolar. This anesthetic technique also produced high success of buccal tissue anesthesia, but demonstrated very low success for palatal tissue anesthesia.

Clinical relevance

Single buccal infiltration to maxillary first molar is potent enough for pulpal and buccal tissue anesthesia, except palatal tissue anesthesia, in both first molar and second premolar.

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References

  1. Evans G, Nusstein J, Drum M, Reader A, Beck M (2008) A prospective, randomized, double-blind comparison of articaine and lidocaine for maxillary infiltrations. J Endod 34:389–393

    Article  Google Scholar 

  2. Hass DA, Harper DG, Saso MA, Young ER (1991) Lack of differential effect by Ultracaine (articaine) and Citanest (prilocaine) in infiltration anaesthesia. J Can Dent Assoc 57:217–223

    Google Scholar 

  3. Hass DA, Harper DG, Saso MA, Young ER (1990) Comparison of articaine and prilocaine anesthesia by infiltration in maxillary and mandibular arches. Anesth Prog 37:230–237

    Google Scholar 

  4. Malamed SF (2013) Handbook of local anaesthesia, 6th edn. Mosby, St Louis

    Google Scholar 

  5. Cui L, Zhang Z, Huang J, Yin D, Xu L (2018) Extraction of permanent maxillary teeth without palatal injection: a meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 126:e187–e195

    Article  Google Scholar 

  6. Bataineh AB, Al-Sabri GA (2017) Extraction of maxillary teeth using articaine without a palatal injection: a comparison between the anterior and posterior regions of the maxilla. J Oral Maxillofac Surg 75:87–91

    Article  Google Scholar 

  7. Kandasamy S, Elangovan R, John RR, Kumar N (2015) Removal of maxillary teeth with buccal 4% articaine without using palatal anesthesia—A comparative double blind study. J Oral Maxillofac Surg Med Pathol 27:154–158

    Article  Google Scholar 

  8. Junior JLL, Dias-Ribeiro E, Ferreira-Rocha J, Soares R, Costa FWG, Fan S, Sant’ana E, (2013) Comparison of buccal infiltration of 4% articaine with 1:100,000 and 1:200,000 epinephrine for extraction of maxillary third molars with pericoronitis: a pilot study. Anesth Prog 60:42–45

    Article  Google Scholar 

  9. Sreekumar K, Bhargava D (2011) Comparison of onset and duration of action of soft tissue and pulpal anesthesia with three volumes of 4% articaine with 1:100,000 epinephrine in maxillary infiltration anesthesia. J Oral Maxillofac Surg 15:195–199

    Article  Google Scholar 

  10. Srinivasan N, Kavitha M, Loganathan CS, Padmini G (2009) Comparison of anesthetic efficacy of 4% articaine and 2% lidocaine for maxillary buccal infiltration in patients with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:133–136

    Article  Google Scholar 

  11. Kanaa MD, Whitworth JM, Meechan JG (2012) A comparison of the efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine in achieving pulpal anesthesia in maxillary teeth with irreversible pulpitis. J Endod 38:279–282

    Article  Google Scholar 

  12. Nagendrababu V, Duncan HF, Whitworth J, Nakoofar MH, Pulikkotil SJ, Veettil SK, Dummer PMH (2020) Is articaine more effective than lidocaine in patients with irreversible pulpitis? An umbrella review. Int Endod J 53:200–213

    Article  Google Scholar 

  13. Paterakis K, Schmitter M, Said Yekta-Michael S (2018) Efficacy of epinephrine-free articaine compared to articaine with epinephrine (1:100 000) for maxillary infiltration, a randomised clinical trial. J Oral Rehabil 45:467–475

    Article  Google Scholar 

  14. Kämmerer PW, Seeling J, Alshihri A, Daubländer M (2014) Comparative clinical evaluation of different epinephrine concentrations in 4% articaine for dental local infiltration anesthesia. Clin Oral Invest 18:415–421

    Article  Google Scholar 

  15. Ahn J, Pogrel MA (1998) The effect of 2% lidocaine with 1:100,000 epinephrine on pulpal and gingival blood flow. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:197–202

    Article  Google Scholar 

  16. Zheng QH, Hong QC, Zhang L, Ye L, Huang DM (2018) A clinical study on the effect of injection sites on efficacy of anesthesia and pulpal blood flow in carious teeth. Oper Dent 43:22–30

    Article  Google Scholar 

  17. Vongsavan K, Samdrup T, Kijsamanmith K, Rirattanapong P, Vongsavan N (2019) The effect of intraosseous local anesthesia of 4% articaine with 1:100,000 epinephrine on pulpal blood flow and pulpal anesthesia of mandibular molars and canines. Clin Oral Invest 23:673–680

    Article  Google Scholar 

  18. Premdas CE, Pitt Ford TR (1995) Effect of palatal injections on pulpal blood flow in premolars. Endod Dent Traumatol 11(6):274–278

    Article  Google Scholar 

  19. Kijsamanmith K, Timpawat S, Vongsavan N, Matthews B (2011) Pulpal blood flow recorded from human premolar teeth with a laser Doppler flow meter using either red or infrared light. Arch Oral Biol 56(7):629–633

    Article  Google Scholar 

  20. Samdrup T, Kijsamanmith K, Vongsavan K, Rirattanapong P, Vongsavan N (2021) The effect of inferior alveolar nerve block anesthesia of 4% articaine and epinephrine 1:100,000 on blood flow and anesthesia of human mandibular teeth. J Dent Sci 16:249–255

    Article  Google Scholar 

  21. Dreven L, Reader A, Beck M, Meyers WJ, Weaver J (1987) An evaluation of an electric pulp tester as a measure of analgesia in human vital teeth. J Endod 13:233–238

    Article  Google Scholar 

  22. Certosimo A, Archer R (1996) A clinical evaluation of the electric pulp tester as an indicator of local anesthesia. Oper Dent 21:25–30

    PubMed  Google Scholar 

  23. Fowler S, Drum M, Reader A, Nusstein J, Beck M (2019) Pulpal anesthesia of adjacent teeth following infiltration of 2% lidocaine with 1:100,000 epinephrine in the maxillary lateral incisor and first molar. Anesth Prog 66:14–19

    Article  Google Scholar 

  24. Nusstein J, Wood M, Al R, Beck M, Weaver J (2005) Comparison of the degree of pulpal anesthesia achieved with the intraosseous injection and infiltration injection using 2% lidocaine with 1:100,000 epinephrine. Gen Dent 53:50–53

    PubMed  Google Scholar 

  25. Vongsavan N, Matthews B (1992) Changes in pulpal blood flow and in fluid flow through dentine produced by autonomic and sensory nerve stimulation in the cat. Proc Fin Dent Soc 88(suppl 1):491–497

    Google Scholar 

  26. Pitt Ford TR, Seare MA, McDonald F (1993) Action of adrenaline on the effect of dental local anaesthetic solutions. Endod Dent Traumatol 9:31–35

    Article  Google Scholar 

  27. Pereira LAP, de Ca´ssia Bergamaschi C, CamaRamacciato J, Ranamli J (2013) Articaine (4 %) with epinephrine (1:100,000 or 1:200,000) in intraosseous injections in symptomatic irreversible pulpitis of mandibular molars: anesthetic efficacy and cardiovascular effects. Oral Surg Oral Med Oral Pathol Oral Radiol 116(2):e85-91

    Article  Google Scholar 

  28. Lasemi E, Sezavar M, Habibi L, Hemmat S, Sarkarat F, Nematollahi Z (2015) Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in inferior alveolar nerve block: effects on the vital signs and onset, and duration of anesthesia. J Dent Anesth Pain Med 15:201–205

    Article  Google Scholar 

  29. Santos CF, Modena KC, Giglio FP, Sakai VT, Calvo AM, Colombini BL et al (2007) Epinephrine concentration (1:100,000 or 1:200,000) does not affect the clinical efficacy of 4% articaine for lower third molar removal: a double-blind, randomized, crossover study. J Oral Maxillofac Surg 65:2445–2452

    Article  Google Scholar 

  30. Tofoli GR, Ramacciato JC, Oliveira PC, Volpato MC, Groppo FC, Ranali J (2003) Comparison of effectiveness of 4% articaine associated with 1:100,000 or 1:200,000 epinephrine in inferior alveolar nerve block. Anesth Prog 50:164–168

    PubMed  PubMed Central  Google Scholar 

  31. Hassan S, Rao BH, Sequeria J, Rai G (2011) efficacy of 4% articaine hydrochloride and 2% lignocaine hydrochloride in the extraction of maxillary premolars for orthodontic reasons. Ann Maxillofac Surg 1:14–18

    Article  Google Scholar 

  32. Kumar DP, Sharma M, Patil V, Subedar RS, Lakshmi GV, Manjunath NV (2019) Anesthetic efficacy of single buccal infiltration of 4% articaine and 2% lignocaine in extraction of maxillary 1st molar. Ann Maxillofac Surg 9:239–246

    Article  Google Scholar 

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Acknowledgements

This study was supported by Faculty of Dentistry, Mahidol University, Bangkok, Thailand. The authors would like to express sincere gratitude to all staff of Prestige clinic, Dental hospital, Faculty of Dentistry, Mahidol University for their support and assistance.

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Authors and Affiliations

  1. Department of Oral Biology, Faculty of Dentistry, Mahidol University, Yothi Road, Bangkok, 10400, Thailand

    Kanittha Kijsamanmith, Chayanit Sriworapongpun, Nichanan Pawasut, Nadpatchamon Huayhongthong, Thanawin Sakulyuenyong & Piyatida Krongyoungyuen

  2. Dental Department, Lungtenphu Military Hospital, Royal Bhutan Army, 11001, Thimphu, Bhutan

    Tshering Samdrup

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  1. Kanittha Kijsamanmith
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  2. Chayanit Sriworapongpun
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Correspondence to Kanittha Kijsamanmith.

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Kijsamanmith, K., Sriworapongpun, C., Pawasut, N. et al. The effect of single buccal infiltration anesthesia of 4% articaine with either 1:100,000 or 1:200,000 epinephrine on pulpal blood flow and anesthesia of maxillary first molars and second premolars in humans. Clin Oral Invest 26, 343–351 (2022). https://doi.org/10.1007/s00784-021-04005-4

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