Hyaluronidase Increases the Duration of Mepivacaine in Inferior Alveolar Nerve Blocks

Tempestini Horliana, Anna Carolina Ratto; de Brito, Mayara Aguilar Dias; Perez, Flávio Eduardo Guillin; Simonetti, Maria Prazeres Barbalho; Rocha, Rodney Garcia; Borsatti, Maria Aparecida

doi:10.1016/j.joms.2007.06.628

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 2 , Pages 286-290, February 2008

Hyaluronidase Increases the Duration of Mepivacaine in Inferior Alveolar Nerve Blocks

Anna Carolina Ratto Tempestini Horliana, MDS
- Masters Degree Student, Integrated Dental Clinic, Department of Estomatology, College of Dentistry, University of São Paulo, São Paulo, Brazil.
- Address correspondence and reprint requests to Dr Tempestini Horliana: Faculdade de Odontologia da Universidade de São Paulo, Av Professor Lineu Prestes, 2227, Cidade Universitária, 05508-900 São Paulo, Brazil
Mayara Aguilar Dias de Brito, DDS
- Investigator, Integrated Dental Clinic, Department of Estomatology, College of Dentistry, University of São Paulo, São Paulo, Brazil.
Flávio Eduardo Guillin Perez, PhD
- Professor, Integrated Dental Clinic, Department of Estomatology, College of Dentistry, University of São Paulo, São Paulo, Brazil.
Maria Prazeres Barbalho Simonetti, PhD
- Professor, Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
Rodney Garcia Rocha, PhD
- Professor and Chairman, Integrated Dental Clinic, Department of Estomatology, College of Dentistry, University of São Paulo, São Paulo, Brazil.
Maria Aparecida Borsatti, PhD
- Professor, Integrated Dental Clinic, Department of Estomatology, College of Dentistry, University of São Paulo, São Paulo, Brazil.

Purpose

To evaluate the duration of the effect of mepivacaine when hyaluronidase is injected immediately prior to the end of pulpal anesthesia.

Patients and Methods

Forty bilateral, symmetrical third molar surgeries were performed in 20 healthy patients. Inferior alveolar nerve block was induced using 2.8 mL 2% mepivacaine with epinephrine. Hyaluronidase (75 turbidity-reducing units) or a placebo was injected 40 minutes after the beginning of pulpar anesthesia (randomized and double-blind trial). The duration of effect in the pulpal and gingival tissues was evaluated by response to painful electrical stimuli applied to the adjacent premolar, and by mechanical stimuli (pin prick) to the vestibular gingiva, respectively.