Testing the Anesthetic Effectiveness of Three Different Dental Local Anesthetics Injected Next to a Lower First Molar
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | Any |
| Updated: | 10/21/2012 |
| Start Date: | May 2012 |
| Contact: | Brett Nydegger, DDS |
| Email: | brett.nydegger@gmail.com |
| Phone: | (614) 292-5399 |
Anesthetic Efficacy of 4% Articaine With 1:100,000 Epinephrine, 4% Prilocaine With 1:200,000 Epinephrine, and 4% Lidocaine With 1:100,000 Epinephrine as a Primary Buccal Infiltration in the Mandibular First Molar.
Infiltration (injecting next to the tooth) injections are common in dentistry and a number
of studies have shown that articaine anesthetic, when injected next to the tooth as a
supplemental injection, works very well following a typical inferior alveolar (lower jaw)
nerve block. No study has compared 4% articaine with 1:100,000 epinephrine, 4% prilocaine
with 1:200,000 epinephrine, and 4% lidocaine with 1:100,000 epinephrine in mandibular (lower
jaw) infiltration injections of the first molar. The purpose of this prospective,
randomized, double-blind, crossover study is to compare the degree of anesthesia obtained
from the three solutions as a primary infiltration injection next to the mandibular first
molar. The investigators also will record the pain of injection and postoperative pain.
Using a crossover design, 60 adult subjects will receive three injections consisting of a
primary mandibular first molar infiltration of 1.8 mL of 4% articaine with 1:100,000
epinephrine, 1.8 mL of 4% prilocaine with 1:200,000 epinephrine, and 1.8 mL of 4% lidocaine
with 1:100,000 epinephrine in three separate appointments spaced at least one week apart.
With the crossover design, 180 infiltrations will be given for the first molar and each
subject will serve as his or her own control. Ninety infiltrations will be administered on
the mandibular left side and ninety administered on the mandibular right side. The order of
the three injections will be assigned randomly and the dentist and subject will be blinded
about which anesthetic the subject is given. The anesthetics used in this study are not
experimental. An electric pulp tester will be used to test the lower back teeth (molars and
premolars) for anesthesia in 3-minute time intervals for a total of 60 minutes. The pain of
injection and postoperative pain will be recorded in a survey. The data will be
statistically analyzed.
Inclusion Criteria:
- between the ages of 18 and 65 years.
- in good health (ASA classification II or lower).
- able to provide informed consent.
Exclusion Criteria:
- allergy to articaine, lidocaine or prilocaine.
- history of significant medical problems (ASA classification III or greater).
- depression (taking tri-cyclic antidepressant medications to control).
- have taken CNS depressants (including alcohol or any analgesic medications) within
the last 48 hours prior to testing.
- lactating or pregnant.
- inability to give informed consent.
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