Tuesday, November 15, 2016

Effects of Two Different Anesthetic Solutions on Injection Pain, Efficacy, and Duration of Soft-Tissue Anesthesia with Inferior Alveolar Nerve Block for Primary Molars

Ülkü Şermet Elbay, Mesut Elbay, Emine Kaya, and Sinem Yıldırım (2016) Effects of Two Different Anesthetic Solutions on Injection Pain, Efficacy, and Duration of Soft-Tissue Anesthesia with Inferior Alveolar Nerve Block for Primary Molars. Journal of Clinical Pediatric Dentistry: 2016, Vol. 40, No. 6, pp. 456-463. 


Objectives: The purpose of the study was to compare the efficacy, injection pain, duration of soft tissue anesthesia, and postoperative complications of two different anesthetics (2% lidocaine with 1:80,000 epinephrine and 3% plain mepivacaine) in pediatric patients in inferior alveolar nerve block (IANB) administered by a computer-controlled delivery system (CCDS).  

Study Design: The study was conducted as a randomized, controlled-crossover, double-blind clinical trial with 60 children requiring bilateral pulpotomy or extraction of primary mandibular molars. A CCDS was used to deliver 3% mepivacaine to 1 primary tooth and 2% lidocaine to the contralateral tooth with an IANB technique. Severity of pain and efficacy of anesthesia were evaluated using the Face, Legs, Activity, Cry, Consolability Scale, and comfort and side effects were assessed using a questionnaire. Data were analyzed using the Mann–Whitney U, Wilcoxon t, and Fisher exact tests.  

Results: Patients receiving 2% lidocaine experienced significantly less pain during injection than those receiving 3% mepivacaine, and no significant differences were found in the pain scores during treatments or in postoperative complications between the two anesthetics. The mean durations of anesthesia for 3% mepivacaine and 2% lidocaine were 139.68 minutes and 149.10 minutes, respectively.

Conclusions: Plain mepivacaine and 2% lidocaine were similarly effective in pulpotomy and the extraction of primary mandibular molars. Although the use of 3% mepivacaine provided a shorter duration of anesthesia than 2% lidocaine, both solutions showed similar results in terms of postoperative complications.

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