Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
Associate Professor, Department of Periodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
J Oral Maxillofac Surg. 2021 Aug;79(8):1643-1649. doi: 10.1016/j.joms.2021.02.019. Epub 2021 Feb 24.
This study was conducted to ascertain the efficacy of buccal injection of articaine compared to lidocaine in inducing palatal anesthesia in different maxillary regions.
This double-blinded, randomized clinical trial included 300 patients who referred for extraction of 1 maxillary tooth. The patients were categorized into 3 strata according to the extraction area (anterior, premolar, molar), and then randomly assigned to 2 groups based on the administered medication. The first group received buccal infiltration by 0.6 mL of 2% lidocaine, whereas the second group was buccally administered using 0.6 mL of 4% articaine. After a waiting period of 2 minutes, the failure or success in achieving palatal anesthesia was assessed by the instrumentation technique. In cases of failed anesthesia, an additional 0.6 mL of the same anesthetic was given, and the procedure was repeated if palatal anesthesia was not attained after a 2-minute delay. If pain remained 2 minutes after the third injection, a supplemental palatal infiltration was administered and the extraction was attempted.
The success rate of buccal infiltration in achieving palatal anesthesia was 82.7% in the articaine group and 1.3% in the lidocaine group. There was a significant difference in the success rate and drug volume required to induce palatal anesthesia between the 2 groups (P < .001), but no significant difference was found between different maxillary regions, using either of the medications (P > .05).
Articaine can be considered as a suitable alternative to lidocaine for eliminating painful palatal infiltration in the extraction of maxillary teeth.
本研究旨在确定颊侧注射阿替卡因相对于利多卡因在诱导不同上颌区域腭部麻醉中的效果。
这是一项双盲、随机临床试验，纳入了 300 名因上颌 1 颗牙齿拔除而就诊的患者。患者根据拔牙区域（前牙、前磨牙、磨牙）分为 3 个层，然后根据给予的药物随机分为 2 组。第 1 组接受 0.6 mL 2%利多卡因颊侧浸润，第 2 组接受 0.6 mL 4%阿替卡因颊侧注射。等待 2 分钟后，通过器械技术评估腭部麻醉的失败或成功。如果麻醉失败，给予相同剂量的麻醉剂 0.6 mL，如果 2 分钟后仍未达到腭部麻醉，则再次重复该过程。如果第三次注射后 2 分钟仍有疼痛，给予补充腭侧浸润，并尝试拔牙。
阿替卡因组颊侧注射诱导腭部麻醉的成功率为 82.7%，利多卡因组为 1.3%。两组在诱导腭部麻醉的成功率和所需药物剂量方面存在显著差异（P < 0.001），但使用两种药物时不同上颌区域之间无显著差异（P > 0.05）。
在拔除上颌牙齿时，阿替卡因可以作为利多卡因的替代药物，以消除疼痛的腭侧浸润。
