- 作者：Sara Fowler ; DMD ; MS&lowast ; ; Melissa Drum ; DDS ; MS&lowast ; ; Al Reader ; DDS ; MS&lowast ; ; reader.2@osu.edu" class="auth_mail" title="E-mail the corresponding author ; Mike Beck ; DDS ; MA&dagger ;
- 关键词：Anesthetic success ; articaine ; buccal infiltration ; inferior alveolar nerve block ; irreversible pulpitis ; lidocaine ; mandibular anesthesia
- 刊名：Journal of Endodontics
- 出版年：2016
- 出版时间：March 2016
- 年：2016
- 卷：42
- 期：3
- 页码：390-392
- 全文大小：92 K
Methods
As part of 6 studies, 375 emergency patients presenting with symptomatic irreversible pulpitis received 2% lidocaine with 1:100,000 epinephrine via an IAN block. After profound lip numbness, endodontic access and instrumentation were initiated. If the patient felt moderate to severe pain, a supplemental buccal infiltration of a cartridge of 4% articaine with 1:100,000 epinephrine was administered (204 patients), and endodontic treatment continued. Success was defined as the ability to access and instrument the tooth without pain (visual analogue scale rating of 0) or mild pain (visual analogue scale rating less than or equal to 54 mm).
Results
IAN block success was 28% for the first molars, 25% for the second molars, and 39% for the premolars. There were no significant differences when comparing molars with premolars. For the supplemental articaine buccal infiltration, success was 42% for the first molars, 48% for the second molars, and 73% for the premolars. There were no significant differences when comparing the molars, but there was a significant difference when comparing the premolars with the molars.
Conclusions
For patients presenting with symptomatic irreversible pulpitis, the success rates for the IAN block and supplemental buccal infiltration of articaine of the molars and premolars would not be high enough to ensure profound pulpal anesthesia.