Department of Physiological Sciences, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil.
J Endod. 2010 Mar;36(3):438-41. doi: 10.1016/j.joen.2009.12.014.
The incisive/mental nerve block (IMNB) could be an alternative to the inferior alveolar nerve block in the mandibular anterior teeth. The effectiveness of articaine has not been tested in IMNB.
This prospective randomized double-blind crossover study compared the anesthetic efficacy of 0.6 mL 4% articaine and 2% lidocaine, both with 1:100.000 epinephrine administered as IMNB to 40 volunteers in two sessions. Pulpal anesthesia of lateral incisor through premolars was tested with an electric pulp tester. The injection and postoperative pain were evaluated by using visual analog scales. The onset (time from the end of injection to the absence of pulpal response) and duration of pulpal anesthesia (time recorded before two positive responses to the pulp tester) and the anesthesia success (two consecutive readings of 80 without response and onset<or=10 minutes) were measured.
Articaine provided a higher success rate (p<0.001) of anesthesia than lidocaine for the lateral incisor (32.5%), the canine (55%), and the first (72.5%) and second (80%) premolars and a faster onset (p<0.05) for canine and increased duration (p<0.05) of anesthesia for premolars. The median duration of premolars anesthesia was 10 and 20 minutes, respectively, with lidocaine and articaine. There were no differences in pain scores between the solutions (p>0.05).
Articaine promoted higher anesthesia success and longer duration of anesthesia than lidocaine for most of the teeth after IMNB although anesthesia success could be considered clinically appropriated only for premolars. The volume of local anesthetic used in the present study may not be appropriate for procedures lasting longer than 10 minutes.
切牙神经阻滞（IMNB）可能是下颌前牙下牙槽神经阻滞的替代方法。阿替卡因在 IMNB 中的效果尚未得到测试。
本前瞻性随机双盲交叉研究比较了 0.6 mL 4%阿替卡因和 2%利多卡因在 40 名志愿者的两次注射中的麻醉效果，均使用含有 1:100,000 肾上腺素的 IMNB。通过电牙髓测试仪测试侧切牙至前磨牙的牙髓麻醉。使用视觉模拟量表评估注射和术后疼痛。记录牙髓麻醉的起始时间（从注射结束到牙髓无反应的时间）和持续时间（记录到牙髓测试仪出现两次阳性反应之前的时间）以及麻醉成功率（两次连续读数为 80 且无反应，起始时间<或=10 分钟）。
阿替卡因用于侧切牙（32.5%）、尖牙（55%）、第一前磨牙（72.5%）和第二前磨牙（80%）的麻醉成功率高于利多卡因（p<0.001），并且尖牙的起始时间更快（p<0.05），前磨牙的麻醉持续时间更长（p<0.05）。利多卡因和阿替卡因用于前磨牙的麻醉持续时间中位数分别为 10 分钟和 20 分钟。两种溶液的疼痛评分无差异（p>0.05）。
阿替卡因在 IMNB 后用于大多数牙齿的麻醉成功率高于利多卡因，麻醉持续时间也更长，尽管仅可认为前磨牙的麻醉成功率在临床上是合适的。本研究中使用的局部麻醉剂体积可能不适用于持续时间超过 10 分钟的手术。
