An evaluation of 4% prilocaine with 1:200,000 epinephrine and 2% mepivacaine with 1:20,000 levonordefrin compared with 2% lidocaine with:100,000 epinephrine for inferior alveolar nerve block.

The purpose of this study was to measure the degree of anesthesia obtained with 4% prilocaine with 1:200,000 epinephrine and 2% mepivacaine with 1:20,000 levonordefrin compared with 2% lidocaine with 1:100,000 epinephrine for inferior alveolar nerve block. Using a repeated measures design, 30 subjects randomly received an inferior alveolar injection using masked cartridges of each solution at three successive appointments. The first molar, first premolar, lateral incisor, and contralateral canine (control) were blindly tested with an Analytic Technology pulp tester at 3-min cycles for 50 min. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading) within 16 min and maintenance of this reading for the remainder of the testing period.Although subjects felt numb subjectively, anesthetic success as defined here occurred in 46% to 57% of the molars, in 50% to 57% of the premolars, and in 21% to 36% of the lateral incisors. No statistically significant differences in onset, success, failure, or incidence were found among the solutions. We conclude that the three preparations are equivalent for inferior alveolar nerve block of 50-min duration.