Haase Andrew, Reader Al, Nusstein John, Beck Mike, Drum Melissa
Endodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA.
J Am Dent Assoc. 2008 Sep;139(9):1228-35. doi: 10.14219/jada.archive.2008.0338.
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 after an inferior alveolar nerve (IAN) block with the use of 4 percent articaine with 1:100,000 epinephrine.
Seventy-three blinded adult subjects randomly received buccal infiltrations at the first molar site with a cartridge of 4 percent articaine with 1:100,000 epinephrine at one appointment and a cartridge of 2 percent lidocaine with 1:100,000 epinephrine at another appointment after receiving a standard IAN block with the use of 4 percent articaine with 1:100,000 epinephrine in a crossover design. After the injections, the authors used an electric pulp tester to test the first molar for anesthesia in three-minute cycles for 60 minutes. They considered anesthesia to be successful when two consecutive 80 readings were obtained within 10 minutes of the IAN block and infiltration injection, and the 80 reading was sustained continuously through the 60th minute.
The authors found that with the use of the 4 percent articaine formulation, successful pulpal anesthesia occurred 88 percent of the time for the first molar. With the 2 percent lidocaine formulation, successful pulpal anesthesia occurred 71 percent of the time. The results show a significant difference (P < .05) between the articaine and lidocaine formulations.
For a mandibular buccal infiltration of the first molar after a standard IAN block, 4 percent articaine with 1:100,000 epinephrine resulted in a higher success rate (88 percent) than did 2 percent lidocaine with 1:100,000 epinephrine (71 percent success rate).
作者进行了一项前瞻性、随机、双盲、交叉研究，比较在下牙槽神经（IAN）阻滞麻醉使用含1:100,000肾上腺素的4%阿替卡因后，通过下颌第一磨牙颊侧浸润两种麻醉溶液（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）所达到的牙髓麻醉程度。
73名不知情的成年受试者采用交叉设计，在接受含1:100,000肾上腺素的4%阿替卡因标准IAN阻滞麻醉后，一次就诊时在第一磨牙部位接受含1:100,000肾上腺素的4%阿替卡因药筒颊侧浸润，另一次就诊时接受含1:100,000肾上腺素的2%利多卡因药筒颊侧浸润。注射后，作者使用牙髓电活力测试仪，以三分钟为周期对第一磨牙进行60分钟的麻醉测试。若在IAN阻滞麻醉和浸润注射后10分钟内连续获得两次80读数，且该80读数持续至第60分钟，则认为麻醉成功。
作者发现，使用4%阿替卡因制剂时，第一磨牙牙髓麻醉成功率为88%。使用2%利多卡因制剂时，牙髓麻醉成功率为71%。结果显示阿替卡因和利多卡因制剂之间存在显著差异（P < .05）。
在标准IAN阻滞麻醉后进行下颌第一磨牙颊侧浸润时，含1:100,000肾上腺素的4%阿替卡因的成功率（88%）高于含1:100,000肾上腺素的2%利多卡因（成功率71%）。
