[show abstract][hide abstract] ABSTRACT: Abstract Objectives. The aim of this study was to evaluate the possible toxic effects of articaine and lidocaine on mental nerve, due to the increasing number of paresthesia cases after nerve blocks. Materials and methods. The drugs were injected in the anterior portion of mental nerve of 24 rats, divided into three groups: G1-4% articaine with 1:100,000 epinephrine; G2-2% lidocaine with 1:100,000 epinephrine and G3-plain 1:100,000 epinephrine solution. These solutions were injected in the right side of the rat's mandible and the left side was used as control (0.9% saline solution). Previously to the injections, the animals were anesthetized with thiopental and, 24 h after the injections, their jaws were removed and submitted to routine histological techniques. A histopathological analysis was performed by optical microscopy. Results. An inflammatory infiltration was found around mental nerve, classified as intense for G3, moderate for G1 and light for both G2 and control groups. No injuries were found in nervous structure, despite the inflammatory reaction observed around it. Conclusion. The results suggest that articaine is not toxic to the nervous structure and further studies are necessary to explain the possible relation between articaine injection and paresthesia.
[show abstract][hide abstract] ABSTRACT: The incisive/mental nerve block (IMNB) could be an alternative to the inferior alveolar nerve block in the mandibular anterior teeth. The effectiveness of articaine has not been tested in IMNB.
This prospective randomized double-blind crossover study compared the anesthetic efficacy of 0.6 mL 4% articaine and 2% lidocaine, both with 1:100.000 epinephrine administered as IMNB to 40 volunteers in two sessions. Pulpal anesthesia of lateral incisor through premolars was tested with an electric pulp tester. The injection and postoperative pain were evaluated by using visual analog scales. The onset (time from the end of injection to the absence of pulpal response) and duration of pulpal anesthesia (time recorded before two positive responses to the pulp tester) and the anesthesia success (two consecutive readings of 80 without response and onset<or=10 minutes) were measured.
Articaine provided a higher success rate (p<0.001) of anesthesia than lidocaine for the lateral incisor (32.5%), the canine (55%), and the first (72.5%) and second (80%) premolars and a faster onset (p<0.05) for canine and increased duration (p<0.05) of anesthesia for premolars. The median duration of premolars anesthesia was 10 and 20 minutes, respectively, with lidocaine and articaine. There were no differences in pain scores between the solutions (p>0.05).
Articaine promoted higher anesthesia success and longer duration of anesthesia than lidocaine for most of the teeth after IMNB although anesthesia success could be considered clinically appropriated only for premolars. The volume of local anesthetic used in the present study may not be appropriate for procedures lasting longer than 10 minutes.
Journal of endodontics 03/2010; 36(3):438-41. · 2.95 Impact Factor