Robertson Douglas, Nusstein John, Reader Al, Beck Mike, McCartney Melissa
College of Dentistry, The Ohio State University, Columbus, USA.
J Am Dent Assoc. 2007 Aug;138(8):1104-12. doi: 10.14219/jada.archive.2007.0324.
The authors conducted a prospective, randomized, double-blind, crossover study comparing the degree of pulpal anesthesia achieved by means of mandibular first molar buccal infiltrations of two anesthetic solutions: 4 percent articaine with 1:100,000 epinephrine and 2 percent lidocaine with 1:100,000 epinephrine.
Each of 60 blinded adult subjects randomly received two buccal infiltrations at the first molar site: one cartridge of 4 percent articaine with 1:100,000 epinephrine at one appointment and one cartridge of 2 percent lidocaine with 1:100,000 epinephrine at another appointment. The injections were administered during two separate appointments spaced at least one week apart. The authors used an electric pulp tester to assess the first and second molars and the first and second premolars for pulpal anesthesia in three-minute cycles for 60 minutes. They considered anesthesia to be successful when they obtained two consecutive pulp test readings of 80 (meaning the subject evidenced no response at the maximum output on the pulp tester).
With the lidocaine formulation, successful pulpal anesthesia ranged from 45 to 67 percent. With the articaine formulation, successful pulpal anesthesia ranged from 75 to 92 percent. There was a significant difference (P < .05) in anesthetic success between the lidocaine and articaine formulations for each of the four teeth. Pulpal anesthesia declined slowly over 60 minutes with both formulations.
For a mandibular buccal infiltration of the first molar, 4 percent articaine with 1:100,000 epinephrine will result in a higher success rate than will 2 percent lidocaine with 1:100,000 epinephrine, but the duration of pulpal anesthesia will decline over 60 minutes with either formulation.
作者进行了一项前瞻性、随机、双盲、交叉研究，比较两种麻醉溶液在下颌第一磨牙颊侧浸润麻醉时所达到的牙髓麻醉程度，这两种麻醉溶液分别是：含1:100,000肾上腺素的4%阿替卡因和含1:100,000肾上腺素的2%利多卡因。
60名不知情的成年受试者每人在第一磨牙部位随机接受两次颊侧浸润麻醉：一次就诊时注射一支含1:100,000肾上腺素的4%阿替卡因，另一次就诊时注射一支含1:100,000肾上腺素的2%利多卡因。两次注射在至少间隔一周的两次单独就诊时进行。作者使用牙髓电活力测试仪，以三分钟为一个周期，对第一、第二磨牙以及第一、第二前磨牙进行60分钟的牙髓麻醉评估。当他们获得连续两次牙髓测试读数为80（意味着受试者在牙髓测试仪的最大输出时无反应）时，认为麻醉成功。
使用利多卡因制剂时，牙髓麻醉成功率在45%至67%之间。使用阿替卡因制剂时，牙髓麻醉成功率在75%至92%之间。对于四颗牙齿中的每一颗，利多卡因和阿替卡因制剂在麻醉成功率上均存在显著差异（P < .05）。两种制剂的牙髓麻醉效果在60分钟内均缓慢下降。
在下颌第一磨牙颊侧浸润麻醉时，含1:100,000肾上腺素的4%阿替卡因比含1:100,000肾上腺素的2%利多卡因成功率更高，但两种制剂的牙髓麻醉持续时间在60分钟内都会下降。
