Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
권호 표지
DOI QR코드

DOI QR Code

The anesthetic efficiency of retromolar infiltrations with two local anesthetic solutions of the same concentration in lower third molar surgery

  • Received : 2020.04.08
  • Accepted : 2020.06.08
  • Published : 2020.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Mandibular third molar removal is the most common surgical procedure encountered in oral and maxillofacial clinics. It also presents the greatest challenges and controversies for surgeons when surgical removal is considered. Furthermore, diverse anesthesia results and success rates are achieved after using the same concentrations of different solutions or the same amounts of local anesthetics. The purpose of this study was to examine the efficiency of using double-cartridge (3.4 ml) 4% lidocaine (high concentration) and 4% articaine with a 1:100000 epinephrine infiltration in the retromolar region for impacted lower third molar surgery. Methods: This double-blind study included 30 patients with symmetrically impacted lower third molars. The patients were randomly selected to receive 4% articaine on one side and 4% lidocaine on the other, as a local anesthetic for third molar surgery. The onset, duration of soft-tissue numbness, pulpal sensitivity, amount of additional local anesthetic needed, pain score during the surgical procedure, and duration of the operation were recorded. Results: The results of this research indicate that 86.7% of the operations in the 4% articaine group and 83.3% of those in the 4% lidocaine group were successful. Furthermore, the outcomes in both groups were not statistically significant (P > 0.05). Numbness onset occurred faster in the articaine group than it did in the lidocaine group. However, the duration of soft-tissue anesthesia and pain scores recorded immediately postoperatively were similar. Conclusion: It is concluded that 4% lidocaine and 4% articaine had a similar infiltration efficacy in the retromolar region and both local anesthetics are adequate for impacted lower third molar surgery. There were no statistically significant differences between the two local anesthetics regarding pain control and the duration of soft-tissue numbness during the procedure.

Keywords

References

  1. Shepherd JP, Brickley M.Surgical removal of third molars. BMJ 1994; 309: 620-1. https://doi.org/10.1136/bmj.309.6955.620
  2. Porto GG, Vasconcelos BCDE, Gomes ACA, Albert D. Evaluation of lidocaine and mepivacaine for inferior third molar surgery. Med Oral Patol Oral Cir Bucal 2007; 12: E60-4.
  3. AlHindi M, Rashed B, AlOtaibi N. Failure rate of inferior alveolar nerve block among dental students and interns. Saudi Med J 2016; 37: 84-9. https://doi.org/10.15537/smj.2016.1.13278
  4. Kim C, Hwang KG, Park CJ. Local anesthesia for mandibular third molar extraction. J Dent Anesth Pain Med 2018; 18: 287-94. https://doi.org/10.17245/jdapm.2018.18.5.287
  5. Pogrel MA, Schmidt BL, Sambajon V, Jordan RC. Lingual nerve damage due to inferior alveolar nerve blocks: a possible explanation. J Am Dent Assoc 2003; 134: 195-9. https://doi.org/10.14219/jada.archive.2003.0133
  6. El-Kholey KE. Anesthetic Efficacy of 4% articaine during extraction of the mandibular posterior teeth by using inferior alveolar nerve block and buccal infiltration techniques. J Maxillofac Oral Surg 2017; 16: 90-5. https://doi.org/10.1007/s12663-015-0877-z
  7. Poorni S, Veniashok B, Senthilkumar AD, Indira R, Ramachandran S. Anesthetic efficacy of four percent articaine for pulpal anesthesia by using inferior alveolar nerve block and buccal infiltration techniques in patients with irreversible pulpitis: a prospective randomized doubleblind clinical trial. J Endod 2011; 37: 1603-7. https://doi.org/10.1016/j.joen.2011.09.009
  8. da Silva-Junior GP, de Almeida Souza LM, Groppo FC. Comparison of articaine and lidocaine for buccal infiltration after inferior alveolar nerve block for intraoperative pain control during impacted mandibular third molar surgery. Anesth Prog 2017; 64: 80-4. https://doi.org/10.2344/anpr-64-02-06
  9. Matthews R, Drum M, Reader A, Nusstein J, Beck M. Articaine for supplemental buccal mandibular infiltration anesthesia in patients with irreversible pulpitis when the inferior alveolar nerve block fails. J Endod 2009; 35: 343-6. https://doi.org/10.1016/j.joen.2008.11.025
  10. Jain NK, John RR. Anesthetic efficacy of 4% articaine versus 2% lignocaine during the surgical removal of the third molar: a comparative prospective study. Anesth Essays Res 2016; 10: 356-61. https://doi.org/10.4103/0259-1162.171445
  11. Martin M, Nusstein J, Drum M, Reader A, Beck M. Anesthetic efficacy of 1.8 mL versus 3.6 mL of 4% articaine with 1:100,000 epinephrine as a primary buccal infiltration of the mandibular first molar. J Endod 2011; 37: 588-92. https://doi.org/10.1016/j.joen.2011.01.001
  12. Sawang K, Chaiyasamut T, Kiattavornchareon S, Pairuchvej V, Bhattarai BP, Wongsirichat N. Double versus single cartridge of 4% articaine infiltration into the retromolar area for lower third molar surgery. J Dent Anesth Pain Med 2017; 17: 121-7. https://doi.org/10.17245/jdapm.2017.17.2.121
  13. Shruthi R, Kedarnath N, Mamatha N, Rajaram P, BhadraShetty D, Articaine for surgical removal of impacted third molar; a comparison with lignocaine. J Int Oral Health 2013; 5: 48-53.
  14. Ping B, Kiattavorncharoen S, Durward C, Im P, Saengsirinavin C, Wongsirichat N. Hemodynamic changes associated with a novel concentration of lidocaine HCl for impacted lower third molar surgery. J Dent Anesth Pain Med 2015; 15: 121-8. https://doi.org/10.17245/jdapm.2015.15.3.121
  15. Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res 2018; 11: 851-6. https://doi.org/10.2147/JPR.S158847
  16. Lima CJ, Silva LC, Melo MR, Santos JA, Santos TS. Evaluation of the agreement by examiners according to classifications of third molars. Med Oral Patol Oral Cir Bucal 2012; 17: e281-6.
  17. Oertel R, Rahn R, Kirch W. Clinical pharmacokinetics of articaine. Clin Pharmacokinet 1997; 33: 417-25. https://doi.org/10.2165/00003088-199733060-00002
  18. Meechan JG, Kanaa MD, Corbett IP, Steen IN, Whitworth JM. Pulpal anaesthesia for mandibular permanent first molar teeth: a double-blind randomized cross-over trial comparing buccal and buccal plus lingual infiltration injections in volunteers. Int Endod J 2006; 39: 764-9. https://doi.org/10.1111/j.1365-2591.2006.01144.x
  19. Nydegger B, Nusstein J, Reader A, Drum M, Beck M. Anesthetic comparisons of 4% concentrations of articaine, lidocaine, and prilocaine as primary buccal infiltrations of the mandibular first molar: a prospective randomized, double-blind study. J Endod 2014; 40: 1912-6. https://doi.org/10.1016/j.joen.2014.08.001
  20. Malamed SF. Handbook of local anesthesia. 5th ed. Philadelphia, Elsevier's Health Sciences. 2004.
  21. Malamed SF, Gagnon S, Leblanc D. Articaine hydrochloride: a study of the safety of a new amide local anesthetic. J Am Dent Assoc 2001; 132: 177-85. https://doi.org/10.14219/jada.archive.2001.0152
  22. Weinberg L, Peake B, Tan C, Nikfarjam M. Pharmacokinetics and pharmacodynamics of lignocaine: A review. World J Anesthesiol 2015; 4: 17-29. https://doi.org/10.5313/wja.v4.i2.17
  23. Awad S, Mourad SI. Extraction of mandibular posterior teeth: Comparison between standard inferior alveolar nerve block and local infiltration anesthesia. Egypt Dent J 2020; 66: 107-12. https://doi.org/10.21608/edj.2020.77521

Cited by

  1. Twin Mixed Local Anesthesia in Third Molar Surgery - Randomized Controlled Trial vol.80, pp.1, 2020, https://doi.org/10.1016/j.joms.2021.07.013