Efficacy and Safety of 2% and 4% Articaine for Lower Third Molar Surgery

Author(s)

Senes, A. M. ; Calvo, A. M. ; Colombini-Ishikiriama, B. L. ; Goncalves, P. Z. ; Dionisio, T. J. ; Sant'ana, E. ; Brozoski, D. T. ; Lauris, J. R. P. ; Faria, F. A. C. ; Santos, C. F.

• Document type: Journal article
• Source: JOURNAL OF DENTAL RESEARCH; v. 94, n. 9, p. 8-pg., 2015-09-01.

Abstract

This double-blind crossover randomized clinical trial compared the efficacy of 2 concentrations of articaine, 2% (A2) and 4% (A4), with 1:200,000 epinephrine, for lower third molar removal. During 2 separate appointments with either A2 or A4, both similarly positioned lower third molars in 46 volunteers were extracted. The following were evaluated: onset and duration of anesthetic action on soft tissues, intraoperative bleeding, hemodynamic parameters, postoperative analgesia, and mouth opening and wound healing during the 7th postoperative day, along with the incidence, type, and severity of adverse reactions. Nearly identical volumes of both anesthetic solutions were used for each appointment: 3.4 +/- 0.9 mL approximate to 68 mg of articaine (A2) and 3.3 +/- 0.8 mL approximate to 132 mg of articaine (A4). Statistical analysis indicated no differences in onset or duration of anesthetic action on soft tissues or duration of postoperative analgesia evoked by A2 and A4 anesthetic solutions (P > 0.05). The surgeon's rating of intraoperative bleeding was considered minimal throughout all surgery with both anesthetic solutions. While transient changes in blood pressure, heart rate, and oxygen saturation were observed, these factors were clinically insignificant and were uninfluenced by articaine concentration (P > 0.05). No systemic or local adverse reactions were observed in the preoperative and postoperative periods due to A2 or A4, but 1 case of bilateral paresthesia was observed. There were no significant differences between preoperative and postoperative (7th day) values of mouth opening and wound healing whether volunteers received A2 or A4 (P > 0.05). In conclusion, both A2 and A4, administered in equal volumes, were effective and safe during lower third molar surgery, and no significant differences were found between their efficacy and safety (ClinicalTrials.gov NCT02457325). (AU)

• FAPESP's process: 09/15372-5 - Interaction between the renin-angiotensin system and the vascular endothelial growth factor in the experimentally-induced periodontal disease in rats
• Grantee: Daniel Thomas Brozoski
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 10/16985-8 - Comparative analysis between 2% and 4% articaine, both with 1:200,000 epinephrine: evaluation of anesthetics efficacy, intraoperative bleeding and hemodynamic parameters in lower third molar removals
• Grantee: Carlos Ferreira dos Santos
• Support Opportunities: Regular Research Grants
• FAPESP's process: 09/17851-8 - Influence of cytochrome P450 (CYP2C9) genotype on the clinical efficacy and pharmacokinetics of piroxicam after lower third molar surgery
• Grantee: Adriana Maria Calvo
• Support Opportunities: Scholarships in Brazil - Post-Doctoral