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Dental Abstracts

Volume 62, Issue 3, May–June 2017, Pages 156-157
Dental Abstracts

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Mepivacaine versus lidocaine

https://doi.org/10.1016/j.denabs.2016.12.037Get rights and content

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Background

The pain of irreversible pulpitis is caused by acute pulp inflammation. This inflammation causes vasodilation, increased vascular permeability, and leukocyte leakage. The pulp is confined and unable to expand, resulting in increased internal tissue pressure. Mepivacaine and lidocaine are both used in such situations to provide pain relief. Inferior alveolar nerve (IAN) blocks have success rates of 62% to 96% and may not always provide sufficient relief for the success of the clinical procedure

Methods

The 42 patients with irreversible pulpitis were seen in the emergency department of the University of São Paulo School of Dentistry. They were randomly assigned to receive conventional IAN block with 1.8 or 3.6 mL of either 2% mepivacaine or 2% lidocaine, both with 1:100,000 epinephrine. They subjectively assessed their lip anesthesia. Electric pulp stimulation was used to assess the absence or presence of pulpal anesthesia, while a verbal analog scale was used to evaluate the absence or

Results

Subjective lip anesthesia was reported by 10 minutes after the IAN block in all patients. Ten patients (3 mepivacaine and 7 lidocaine) did not reach the maximum output of the electric pulp tester without feeling pain even after receiving a second cartridge of anesthetic and were eliminated from the study.

Fifty-two percent of the mepivacaine patients and 33% of the lidocaine patients had pulpal anesthesia with a single cartridge of anesthetic (Fig 2). After administration of a second cartridge,

Discussion

Patients receiving lidocaine reported pain significantly more often than those receiving mepivacaine. Although the electric pulp testing results were similar for the two anesthetics, mepivacaine users required fewer injections and smaller volumes of the drug. Mepivacaine was therefore considered more effective than lidocaine for achieving IAN block for the performance of pulpectomy.

Clinical Significance

Lidocaine had a pulpal anesthesia rate of 67%, whereas mepivacaine had a rate of 86%. IAN

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Visconti RP, Tortamano IP, Buscariolo IA: Comparison of the anesthetic efficacy of mepivacaine and lidocaine in patients with irreversible pulpitis: A double-blind randomized clinical trial. J Endod 42:1314-1319, 2016

Reprints available from RP Visconti, Univ of São Paulo School of Dentistry, Stomatology, São Paulo, SP, Brazil; e-mail: [email protected]

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