Journal of Dental Anesthesia and Pain Medicine

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

DOI QR Code

Anesthetic efficacy and safety of 2% lidocaine hydrochloride with 1:100,000 adrenaline and 4% articaine hydrochloride with 1:100,000 adrenaline as a single buccal injection in the extraction of maxillary premolars for orthodontic purposes

  • Deshpande, Nupoor (Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College, DMIMS) ;
  • Jadhav, Anendd (Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College, DMIMS) ;
  • Bhola, Nitin (Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College, DMIMS) ;
  • Gupta, Manan (Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College, DMIMS)
  • Received : 2020.05.19
  • Accepted : 2020.07.09
  • Published : 2020.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Palatal injection of local anesthetics is the most painful injection. To obviate the need for palatal injections, local anesthetic agents with diffusibility are being investigated. Hence the present study was designed to analyze the anesthetic efficacy of 2% lidocaine hydrochloride (HCl) with 1:100,000 adrenaline and 4% articaine hydrochloride (HCl) with 1:100,000 adrenaline using single buccal infiltration for the extraction of maxillary premolars. Methods: A prospective, double-blind, crossover, randomized clinical study was performed on 60 consecutive systemically healthy patients with an age range of 15-30 years, requiring extraction of asymptomatic bilateral maxillary premolars for orthodontic purposes. They received 1ml buccal infiltration of 4% articaine HCl with 1:100,000 adrenaline on one side and 2% lidocaine HCl with 1:100,000 adrenaline on the other side. The extraction procedure on either side was scheduled 14 days apart. Parameters assessed were the time of onset of anesthesia, intraoperative discomfort, hemodynamic parameters, and the duration of analgesia. Analysis of the data was done using the Mann-Whitney test, the Wilcoxon test, the Kruskal-Wallis ANOVA test, and the chi-square test. Statistical significance was established at P < 0.05. Results: Articaine showed a faster time of onset and longer duration of analgesia than lidocaine. However, the difference in the intraoperative discomfort and hemodynamic parameters was statistically insignificant. Conclusion: Within the limitations of the study, it can be concluded that the extraction of maxillary premolars can be performed with a single buccal infiltration of 2% lidocaine HCl with 1:100,000 adrenaline, which is one of the most commonly used local anesthetic agent.

Keywords

References

  1. Ruetsch YA, Boni T, Borgeat A. From cocaine to ropivacaine: the history of local anesthetic drugs. Curr Top Med Chem 2001; 1: 75-82.
  2. Sreekumar K, Bhargava D. A prospective randomized double-blind study to assess the latency and efficacy of articaine and lignocaine in surgical removal of impacted mandibular third molars in Indian patients. Int J Stomatol Occlusion Med 2012; 5: 10-4. https://doi.org/10.1007/s12548-011-0031-6
  3. Yapp KE, Hopcraft MS, Parashos P. Articaine: A review of the literature. Br Dent J 2011; 210: 323-9. https://doi.org/10.1038/sj.bdj.2011.240
  4. Kumaresan R, Srinivasan B, Pendayala S. Comparison of the effectiveness of lidocaine in permanent maxillary teeth removal performed with single buccal infiltration versus routine buccal and palatal injection. J Maxillofac Oral Surg 2015; 14: 252-7. https://doi.org/10.1007/s12663-014-0624-x
  5. Somuri AV, Rai AV, Pillai M. Extraction of permanent maxillary teeth by only buccal infiltration of articaine. J Maxillofac Oral Surg 2013; 12: 130-2. https://doi.org/10.1007/s12663-012-0396-0
  6. Darawade DA, Kumar S, Budhiraja S, Mittal M, Mehta TN. A clinical study of efficacy of 4% articaine hydrochloride versus 2% lignocaine hydrochloride in dentistry. J Int Oral Health 2014; 6: 81-3.
  7. Bataineh AB, Al-Sabri GA. 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 2017; 75: 87-91. https://doi.org/10.1016/j.joms.2016.06.192
  8. Shital P, Tushar M. Comparison of efficacy of 4% articaine hydrochloride and 2% lignocaine hydrochloride for the orthodontic extraction of bilateral maxillary permanent first premolars. J Res Adv Dent. 2014; 3: 192-8.
  9. Sekhar GR, Nagaraju T, KolliGiri, Nandagopal V, Sudheer R, Sravan. Is palatal injection mandatory prior to extraction of permanent maxillary tooth: a preliminary study. Indian J Dent Res 2011; 22: 100-2. https://doi.org/10.4103/0970-9290.80006
  10. Kumar P, Tripathi L. Challenges in pain assessment: pain intensity scales. INDPAIN 2014; 28: 61-70.
  11. Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Med 2010; 8: 18. https://doi.org/10.1186/1741-7015-8-18
  12. Uckan S, Dayangac E, Araz K. Is permanent maxillary tooth removal without palatal injection possible? Oral Surg Oral Med Oral Pathol Oral Radiol endod 2006; 102: 733-5. https://doi.org/10.1016/j.tripleo.2005.12.005
  13. Kambalimath DH, Dolas RS, Kambalimath HV, Agrawal SM. Efficacy of 4 % articaine and 2 % lidocaine: a clinical study. J Maxillofac Oral Surg 2013; 12: 3-10. https://doi.org/10.1007/s12663-012-0368-4
  14. Ozec I, Tasdemir U, Gumus C, Solak O. Is it possible to anesthetize palatal tissues with buccal 4% articaine injection? J Oral Maxillofac Surg 2010; 68: 1032-7. https://doi.org/10.1016/j.joms.2009.12.023
  15. Mittal M, Sharma S, Kumar A, Chopra R, Srivastava D. Comparison of anaesthetic efficacy of articaine and lidocaine during primary maxillary molar extractions in children. Pediatr Dent. 2015; 37: 520-4.
  16. Kolli NK, Nirmala SV, Nuvvula S. The effectiveness of articaine and lidocaine single buccal versus conventional buccal and palatal injection using lidocaine during primary maxillary molar extraction: a randomized control trial. Anesth Essays Res 2017; 11: 160-4. https://doi.org/10.4103/0259-1162.186589
  17. Malamed SF, Gagnon S, Leblanc D. Articaine hydrochloride: a study of the safety of a new amide local anaesthetic. J Am Dent Assoc 2001; 132: 177-85. https://doi.org/10.14219/jada.archive.2001.0152
  18. Nusstein J, Berlin J, Reader A, Beck M, Weaver JM. Comparison of injection pain, heart rate increase, and postinjection pain of articaine and lidocaine in a rimary intraligamentary injection administered with a computercontrolled local anesthetic delivery system. Anesth Prog 2004; 51: 126-33.

Cited by

  1. Articaine in dentistry: an overview of the evidence and meta-analysis of the latest randomised controlled trials on articaine safety and efficacy compared to lidocaine for routine dental treatment vol.7, pp.1, 2020, https://doi.org/10.1038/s41405-021-00082-5