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A prospective randomized, double-blind study of the anesthetic efficacy of buffered articaine as a primary buccal infiltration of the mandibular first molar.

Shurtz, Ryan H
http://rave.ohiolink.edu/etdc/view?acc_num=osu1408535962

Abstract Details

2014, Master of Science, Ohio State University, Dentistry.
Several studies have demonstrated that 4% articaine with 1:100,000 epinephrine is a superior local anesthetic when used as a primary mandibular buccal infiltration when compared to 2% lidocaine with 1:100,000 epinephrine. However, the anesthetic success has been reported as less than 100% and not predictable enough for routine use. Buffered local anesthetics have been shown to improve anesthetic success, reduce pain of injection, and decrease time to onset of anesthesia. No objective study has addressed the success rate of buffering articaine in a mandibular primary buccal infiltration of the first molar. Therefore, the purpose of this study was to compare the degree of pulpal anesthesia obtained with a buffered 64.8 mg articaine with 16.2 µg epinephrine formulation versus a non-buffered 72.0 mg articaine with 18.0 µg epinephrine formulation as a primary infiltration in the mandibular first molar. Using a crossover design, 80 adults received mandibular buccal infiltrations using 64.8 mg articaine with 16.2 µg epinephrine buffered with 8.4% sodium bicarbonate, and 72 mg articaine with 18 µg epinephrine plain. An electric pulp tester (EPT) 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 two consecutive 80/80 readings with the EPT. Pain ratings for each injection and postoperative pain were recorded. Onset time of pulpal anesthesia was recorded. Data were statistically analyzed. For the buffered articaine formulation, the anesthetic success rate was 71%. For the non-buffered articaine formulation the anesthetic success rate was 65%. There was no significant difference for anesthetic success between buffered articaine and non-buffered articaine (P>0.05). No significant differences were discovered between the two formulations for pain of injection, or onset of anesthesia. Mean anesthesia onset time for buffered articaine and non-buffered articaine was 5.9 min and 5.4 min, respectively. There was a significant difference between anesthetic formulations for female participants regarding postoperative pain ratings for Days 1, 2, and 3 (P=0.000). The highest mean pain ratings were on Day 1 and were slightly in the moderate pain category. The anesthetic efficacy of buffered articaine was not better than non-buffered articaine. The buffered articaine did not provide a decrease in injection pain nor decrease time of onset of anesthesia compared to the non-buffered articaine. Buffered articaine does not provide any advantage over non-buffered articaine for anesthetic efficacy, pain of injection and onset of anesthesia for the mandibular first molar after a primary buccal infiltration.
John Nusstein, DDS, MS (Advisor)
Alfred Reader, DDS, MS (Committee Member)
Melissa Drum, DDS, MS (Committee Member)
Sara Fowler, DMD, MS (Committee Member)
Michael Beck, DDS, MA (Committee Member)
179 p.
Dentistry
articaine, local anesthetics; buffering;

Recommended Citations

Citations

  • Shurtz, R. H. (2014). A prospective randomized, double-blind study of the anesthetic efficacy of buffered articaine as a primary buccal infiltration of the mandibular first molar. [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1408535962

    APA Style (7th edition)

  • Shurtz, Ryan. A prospective randomized, double-blind study of the anesthetic efficacy of buffered articaine as a primary buccal infiltration of the mandibular first molar. 2014. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1408535962.

    MLA Style (8th edition)

  • Shurtz, Ryan. "A prospective randomized, double-blind study of the anesthetic efficacy of buffered articaine as a primary buccal infiltration of the mandibular first molar." Master's thesis, Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1408535962

    Chicago Manual of Style (17th edition)

osu1408535962
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This open access ETD is published by The Ohio State University and OhioLINK.