Department of Oral and Maxillofacial Surgery, Blackpool Victoria Hospital, Blackpool, FY3 2NR.
School of Medicine in Dentistry, Allen Building, University of Central Lancashire, Preston, PR1 2HE.
Br Dent J. 2019 Feb 8;226(3):213-223. doi: 10.1038/sj.bdj.2019.98.
This mini systematic review seeks to analyse the available literature and determine if a 4% articaine solution poses a greater risk of inferior alveolar and/or lingual nerve damage compared to that of 2% lidocaine, when administered for an inferior alveolar nerve block.
After a mini systematic review of the published literature, seven suitable studies were identified: one double-blind random controlled trial (DBRCT) and six retrospective cohort studies. The DBRCT and two of the cohort studies concluded that 4% articaine poses no greater risk of nerve damage. The remaining four cohort studies suggested that caution should be exhibited when using a 4% local anaesthetic solution rather than a 2% solution. However, these studies also concluded that no evidence exists to explain the reasons for their results.
The included articles present no conclusive evidence to suggest that 4% articaine causes more nerve damage than 2% lidocaine, although some authors advise caution when using this agent. All studies conclude that further quality research is required, and it is therefore suggested that dental practitioners exhibit caution when choosing to use 4% articaine in an inferior alveolar nerve block until further scientific research has been performed.
本小型系统评价旨在分析现有文献，以确定在进行下牙槽神经阻滞时，与 2%利多卡因相比，4%阿替卡因溶液是否会增加下牙槽神经和/或舌神经损伤的风险。
对已发表文献进行小型系统评价后，确定了 7 项合适的研究：1 项双盲随机对照试验（DBRCT）和 6 项回顾性队列研究。DBRCT 和其中 2 项队列研究得出结论，4%阿替卡因不会增加神经损伤的风险。其余 4 项队列研究表明，在使用 4%局部麻醉溶液而不是 2%溶液时应谨慎。然而，这些研究也得出结论，没有证据可以解释他们结果的原因。
纳入的文章没有提供确凿的证据表明 4%阿替卡因比 2%利多卡因引起更多的神经损伤，但一些作者建议在使用这种药物时要谨慎。所有研究都得出结论，需要进一步进行高质量的研究，因此建议牙医在选择在下牙槽神经阻滞中使用 4%阿替卡因时要谨慎，直到进一步的科学研究完成。
