| | Epinephrine Concentration (1:100,000 or 1:200,000) Does Not Affect the Clinical Efficacy of 4% Articaine for Lower Third Molar Removal: A Double-Blind, Randomized, Crossover StudyPurposeThis study compared the use of 4% articaine in association with 1:100,000 (10 μg/mL; A100) or 1:200,000 (5 μg/mL; A200) epinephrine in lower third molar removal. Patients and MethodsFifty healthy volunteers underwent removal of symmetrically positioned lower third molars, in 2 separate appointments, under local anesthesia with either A100 or A200, in a double-blind, randomized, and crossed manner. Latency, duration of postoperative analgesia, duration of anesthetic action on soft tissues, intraoperative bleeding, and hemodynamic parameters were evaluated. ResultsA100 and A200 presented very similar latency (1.64 ± 0.08 and 1.58 ± 0.08 minutes, respectively; P > .05). Identical volumes of both anesthetic solutions were used: 2.7 mL = 108 mg of articaine plus 27 μg (A100) or 13.5 μg (A200) of epinephrine. The 2 solutions provided similar duration of postoperative analgesia regardless of bone removal (around 200 minutes; P > .05). The 2 solutions also had a similar duration of anesthetic action on soft tissues (around 250 minutes; P > .05). The surgeon’s rating of intraoperative bleeding was considered very close to minimal. Transient changes in hemodynamic parameters were observed, but these were neither clinically significant nor attributable to the type of anesthetic used (P > .05). ConclusionsAn epinephrine concentration of 1:100,000 or 1:200,000 in 4% articaine solution does not affect the clinical efficacy of this local anesthetic. It is possible to successfully use the 4% articaine formulation with a lower concentration of epinephrine (1:200,000 or 5 μg/mL) for lower third molar extraction with or without bone removal. ⁎ Associate Professor, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. † Dentist, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. ‡ Graduate student, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. § Graduate student, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. ∥ Graduate student, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. ¶ Dentist, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. # Graduate student, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. ⁎⁎ Undergraduate student, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. †† Assistant Professor, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. ‡‡ Professor, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. §§ Assistant Professor, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil.  Address correspondence and reprint requests to Dr Santos: Discipline of Pharmacology, Bauru School of Dentistry, University of São Paulo, Alameda Dr Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo 17012-901, Brazil
PII: S0278-2391(07)00521-6 doi:10.1016/j.joms.2007.04.020 © 2007 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved. | |
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