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Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in intraosseous injections in symptomatic irreversible pulpitis of mandibular molars: anesthetic efficacy and cardiovascular effects

Lookup NU author(s): Dr John Meechan, Juliana Ramacciato


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Objective. The aim of this study was to compare the cardiovascular effects and the anesthetic efficacy of intraosseous injections of 4% articaine with 1:100,000 epinephrine (EPI100) or 4% articaine with 1:200,000 epinephrine (EPI200).Study Design. In this prospective, randomized, double-blind study, 0.9 mL EPI100 and EPI200 solutions were administered for endodontic treatment of mandibular molars with symptomatic irreversible pulpitis in 60 patients. The anesthetic success and pain during anesthesia were evaluated by visual analog scale. The cardiovascular parameters evaluated were heart rate, diastolic/systolic blood pressure, pulse oximetry, and electrocardiogram changes.Results. Both solutions provided high anesthetic efficacy (96.8% and 93.1% for EPI100 and EPI200, respectively; P > .05), and the cardiovascular parameters showed minimal incidences of significant differences throughout the clinical procedure.Conclusions. The epinephrine concentration did not affect the efficacy of 4% articaine, and both solutions produced a high success level of pulpal anesthesia. Intraosseous delivery by slow speed of injection did not induce significant clinical changes in cardiovascular parameters.

Publication metadata

Author(s): Pereira LAP, Groppo FC, Bergamaschi CD, Meechan JG, Ramacciato JC, Motta RHL, Ranali J

Publication type: Article

Publication status: Published

Journal: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Year: 2013

Volume: 116

Issue: 2

Pages: e85-e91

Print publication date: 01/08/2013

Online publication date: 26/07/2012

Acceptance date: 23/10/2011

ISSN (print): 2212-4403

ISSN (electronic): 2212-4411

Publisher: Elsevier BV


DOI: 10.1016/j.oooo.2011.10.045


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