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Tabrizi R, Mazidi A, Sharifzadeh H, Khanzadeh H, Azadi A. Occurrence of neurosensory disturbance after the use of articaine and lidocaine in the inferior alveolar nerve block: a double-blind randomised clinical trial. Br J Oral Maxillofac Surg 2024; 62:637-641. [PMID: 39013713 DOI: 10.1016/j.bjoms.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/13/2024] [Accepted: 06/20/2024] [Indexed: 07/18/2024]
Abstract
This double-blind, randomised clinical trial aimed to find out whether there is a difference in the prevalence of neurosensory disturbance (NSD) between patients who received 2% lidocaine and those who received 4% articaine during inferior alveolar nerve blocks (IANBs). Patients who underwent third molar extraction were randomised into two groups. IANB was performed using 2% lidocaine in Group 1 and 4% articaine in Group 2. The occurrence of NSD was documented. Patients were visited within 48 hours and one week after the tooth was removed. The type of anaesthetic drug (4% articaine versus 2% lidocaine) was the study's predictive factor. A total of 2400 patients were studied in two groups (1200 in each group). The mean (range) age of the patients was 28.40 (18-44) years. Five patients (0.41%) in the lidocaine group and seven (0.58%) in the articaine group had NSD after injection (p = 0.77). The prevalence of NSD after IANB was no higher in the articaine group than in the lidocaine group.
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Affiliation(s)
- Reza Tabrizi
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Mazidi
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadi Sharifzadeh
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ali Azadi
- Dentofacial Deformities Research Center, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Hamouda AA, El-Habashy LM, Khalil A. The use of laser photobiomodulation as pre-anesthetic tissue management technique in reducing injection pain in children. BMC Oral Health 2024; 24:717. [PMID: 38909229 PMCID: PMC11193196 DOI: 10.1186/s12903-024-04430-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 05/31/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND One of the main goals for pediatric dentists is to offer a painless anesthesia experience. Laser photobiomodulation is among the suggested strategies to decrease injection pain. So, this study aimed to assess the impact of laser photobiomodulation on local anesthesia (LA) injection pain in children and its effect on the efficacy of LA during pulpotomy and SSC procedures. METHODS The research was carried out as a randomized controlled clinical trial with two parallel group design. It involved 64 cooperative healthy children, age range from 5 to 7 years, each having at least one maxillary molar indicated for pulpotomy. Children were randomly allocated to one of the two groups based on the pre-anesthetic tissue management technique used: test group received laser photobiomodulation, while control group received topical anesthetic gel. Pain during injection, pulpotomy, and SSC procedures was assessed using physiological measures (Heart Rate (HR)), subjective evaluation (modified Face-Pain-Scale (FPS), and objective analysis (Sound-Eye-Motor scale (SEM)). RESULTS A total of 64 children with mean age 6.23 ± 0.78 participated in this research. The mean HR scores were significantly lower in the laser PBM group during buccal and palatal infiltration injections. The SEM mean scores were significantly lower in the laser PBM group during both injections. For the FPS scale, the number of children who recorded satisfaction during injection was significantly higher in laser PBM group. There was no statistically significant difference in mean HR as well as in SEM and FPS scores between the two groups during pulpotomy and SSC procedures. Comparisons between the two study groups were performed using independent samples t- and Mann-Whitney U tests. Significance was set at p value < 0.05. CONCLUSION Laser photobiomodulation is a promising non-pharmacological pre-anesthetic tissue management technique in children that offered less painful injection compared to topical anesthetic gel without compromising the effectiveness of LA. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05861154. Registered on 16/5/2023.
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Affiliation(s)
- Aliaa Abdelsalam Hamouda
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St, Azarita, Alexandria, 21527, Egypt.
| | - Laila M El-Habashy
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St, Azarita, Alexandria, 21527, Egypt
| | - Amani Khalil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St, Azarita, Alexandria, 21527, Egypt
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Xu X, Zheng X, Lin F, Yu Q, Hou B, Chen Z, Wei X, Qiu L, Wenxia C, Li J, Chen L, Wang Z, Wu H, Lu Z, Zhao J, Liang Y, Zhao J, Pan Y, Pan S, Wang X, Yang D, Ren Y, Yue L, Zhou X. Expert consensus on endodontic therapy for patients with systemic conditions. Int J Oral Sci 2024; 16:45. [PMID: 38886374 PMCID: PMC11183232 DOI: 10.1038/s41368-024-00312-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/13/2024] [Accepted: 05/10/2024] [Indexed: 06/20/2024] Open
Abstract
The overall health condition of patients significantly affects the diagnosis, treatment, and prognosis of endodontic diseases. A systemic consideration of the patient's overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy, as well as selecting appropriate therapeutic approaches. This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence, aiming to provide general guidance on clinical procedures, improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.
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Affiliation(s)
- Xin Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Zheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fei Lin
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University, Beijing, China
| | - Qing Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Benxiang Hou
- Center for Microscope Enhanced Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Zhi Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xi Wei
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Chen Wenxia
- College & Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zuomin Wang
- Department of Stomatology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Hongkun Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Geriatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhiyue Lu
- Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Jizhi Zhao
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuhong Liang
- Department of Emergency, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jin Zhao
- Department of Endodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yihuai Pan
- Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Shuang Pan
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University & Department of Endodontics, School of Stomatology, Harbin Medical University, Harbin, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University, Beijing, China
| | - Deqin Yang
- Department of Conservative Dentistry and Endodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Yanfang Ren
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University, Beijing, China.
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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de Souza Santos S, Bonatto MS, Mendes PGJ, Martins AVB, Pereira DA, de Oliveira GJPL. Efficacy of analgesia promoted by lidocaine and articaine in third molar extraction surgery. A split-mouth, randomized, controlled trial. Oral Maxillofac Surg 2024; 28:919-924. [PMID: 38355872 DOI: 10.1007/s10006-024-01223-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 01/31/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE The aim of this study was to compare the analgesic efficacy of 4% articaine associated with epinephrine (1:100,000), and 2% lidocaine associated with epinephrine (1:100,000) in third molar extraction surgery. METHODS Sixty patients who underwent surgeries to extract upper and lower third molars were included in this split-mouth, double-blind, randomized, controlled trial. The groups in this study were divided according to the anesthetic solution used to provide local anesthesia during extraction of upper and lower third molars: (1) 4% articaine associated with epinephrine (1:100,000); (2) 2% lidocaine associated with epinephrine (1:100,000). The time to the beginning and end of the sensation of analgesia, pain sensation according to the VAS scale, and number of anesthetic tubes necessary for supplementation were analyzed. RESULTS It was found that the onset time for analgesia was shorter on the side anesthetized with articaine compared to the side anesthetized with lidocaine (122.1 ± 52.90 s vs. 144.5 ± 68.85 s) (p < 0.05). In addition, the number of tubes used for anesthetic supplementation was also reduced on the articaine side compared to the lidocaine side (0.26 ± 0.48 vs. 0.50 ± 0.75) (p < 0.05). There were no differences between the anesthetic solutions in the other evaluated parameters. CONCLUSION It can be concluded that the use of 4% articaine associated with epinephrine (1:100,000) reduced the time of onset of analgesia and the necessity for anesthetic supplementation in third molar extraction surgeries compared to the use of 2% lidocaine associated with epinephrine (1:100,000).
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Affiliation(s)
- Samara de Souza Santos
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Periodontology, Pará, Av., 1760-1844 - Umuarama, Uberlândia, MG, 38405-320, Brazil
| | - Mariana Silva Bonatto
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Periodontology, Pará, Av., 1760-1844 - Umuarama, Uberlândia, MG, 38405-320, Brazil
| | - Pedro Gomes Junqueira Mendes
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Periodontology, Pará, Av., 1760-1844 - Umuarama, Uberlândia, MG, 38405-320, Brazil
| | - Ana Vitória Borges Martins
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Periodontology, Pará, Av., 1760-1844 - Umuarama, Uberlândia, MG, 38405-320, Brazil
| | - Davisson Alves Pereira
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Periodontology, Pará, Av., 1760-1844 - Umuarama, Uberlândia, MG, 38405-320, Brazil
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Che Y, Wang M, Wu X, Wang X. The efficacy of articaine in pain management during endodontic procedures in pediatric patients. Perioper Med (Lond) 2024; 13:33. [PMID: 38689354 PMCID: PMC11062012 DOI: 10.1186/s13741-024-00389-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 04/15/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE This trial aimed to study the efficacy of articaine in pain management during endodontic procedures in pediatric patients. METHODS Ninety-eight children who received endodontic painless treatment were collected and randomly divided into the control group and observation group, with 49 cases in each group. The control group received infiltration anesthesia with lidocaine, and the observation group received infiltration anesthesia with articaine. Anesthesia effect, anesthesia onset time, sensory recovery time, duration of anesthesia, pain intensity, blood pressure, heart rate, and adverse reactions were compared. RESULTS The effective rate of anesthesia in the observation group was higher than that in the control group. The anesthesia onset time and sensory recovery time were shorter, the duration of anesthesia was longer, and the VAS score and facial expression score were lower in the observation group than in the control group. The heart rate of the observation group was lower, and diastolic blood pressure was higher than those of the control group. The total incidence of adverse reactions in the observation group was lower than that in the control group. CONCLUSION In the treatment of dental pulp diseases in children, the use of articaine can achieve better anesthesia effect and rapid onset of anesthesia and has less impact on the patient's blood pressure and heart rate, but it also can relieve pain and has good safety after the use of medication. It is worthy of clinical application.
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Affiliation(s)
- Yilei Che
- Department of Stomatology, Aerospace Center Hospital (ASCH), No.15, YuQuan Road, Haidian District, Beijing, 100049, China
| | - Minhua Wang
- Department of Stomatology, Eye Hospital China Academy of Chinese Medical Sciences, Beijing, 100040, China
| | - Xiaozhen Wu
- Department of Stomatology, Aerospace Center Hospital (ASCH), No.15, YuQuan Road, Haidian District, Beijing, 100049, China
| | - Xueling Wang
- Department of Stomatology, Aerospace Center Hospital (ASCH), No.15, YuQuan Road, Haidian District, Beijing, 100049, China.
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Kumar U, Garg N, Vashisht R, Kumari A, Kaur CK, Rajput A. Buccal versus buccal palatal infiltration for pulpal anesthesia using 2% lidocaine and 4% articaine: A randomized controlled trial. J Oral Biol Craniofac Res 2024; 14:205-210. [PMID: 38445050 PMCID: PMC10912647 DOI: 10.1016/j.jobcr.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/01/2024] [Accepted: 02/15/2024] [Indexed: 03/07/2024] Open
Abstract
Background The inability in achieving complete pulpal anesthesia with standard buccal infiltration especially in cases with SIP used for maxillary teeth. The study aimed to compare the anesthetic efficacy of buccal and buccal plus palatal infiltration technique using 2% lidocaine and 4% articaine in permanent maxillary first molars with the diagnosis of symptomatic irreversible pulpitis (SIP). Material and method One hundred and twenty-three patients with clinical diagnosis of SIP, aged 18-50 years were randomly allocated to three treatment groups (N = 41). Group 1(BIL): Buccal infiltration technique using 2% lidocaine with 1:80,000 adrenaline. Group 2(BPIL): combination of buccal plus palatal infiltration using 2% Lidocaine with 1:80,000 adrenaline. Group 3(BIA): Buccal infiltration using 4% articaine with 1:100,000 adrenaline. Pain intensity of patients were recorded before and after the administration of local anesthesia during endodontic procedure that is during caries removal, access preparation and pulp removal using Heft-Parker Visual Analog Scale (HP-VAS). Success was defined by "no pain (0 mm)" or "mild pain (0-54 mm)" during endodontic procedure. The anesthetic efficacy rates were analyzed using chi-square tests, age differences using one-way ANOVA. Results The final analysis included total of 117 patients. Higher success was observed in group II (85%) in comparison to group I (69%) and group III (74%), but the difference was statistically nonsignificant (p > 0.05). Our results demonstrated a nonsignificant difference between genders in all three groups (p > 0.05). Conclusion The use of buccal plus palatal infiltration and 4% articaine can provide effective anesthesia as standard buccal infiltration and 2% lidocaine for patients with SIP in maxillary first molars.
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Affiliation(s)
- Umesh Kumar
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - Nikita Garg
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - Ruchi Vashisht
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - Amrita Kumari
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | | | - Akhil Rajput
- Dr. BSA Medical college and hospital, Rohini, New delhi, India
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Bani-Hani T, Al-Fodeh R, Tabnjh A, Leith R. The Use of Local Anesthesia in Pediatric Dentistry: A Survey of Specialists' Current Practices in Children and Attitudes in Relation to Articaine. Int J Dent 2024; 2024:2468502. [PMID: 38375437 PMCID: PMC10876303 DOI: 10.1155/2024/2468502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 01/20/2024] [Accepted: 02/01/2024] [Indexed: 02/21/2024] Open
Abstract
Aims This study aimed to evaluate the clinical practices of local anesthesia in children. The study also sought to investigate pediatric dentists' views on articaine infiltration anesthesia and their willingness to use it to replace the inferior dental nerve block in primary molars. Materials and Methods A cross-sectional survey was emailed to 183 registered specialists. Descriptive statistics along with chi-square and Fisher's exact tests were used for data analysis. Results A total of 72 responses were received. The sample consisted of 62 (86.1%) females and 10 (13.8%) males with varying levels of experience. The vast majority of respondents (98.6%) used topical anesthesia in their practice with children. The most frequently used anesthetic agent was 2% lidocaine (72.2%) followed by 4% articaine (54.2%). The entire sample indicated that they frequently find difficulties in dose calculation for their child patient. Gender and level of experience did not significantly influence specialists' practice or their knowledge of local anesthesia. More than a third (31.9%) of participants were not happy to replace the block anesthesia with articaine infiltration for the treatment of lower primary molars. The most indicated reasons for this unwillingness were lack of effectiveness (11%) and inadequate scientific evidence (11%). Conclusion Most pediatric dentists used topical anesthesia with children. Lidocaine was the most commonly used injectable local anesthesia. Specialists' current practices of local anesthesia in children generally conformed well to good standards. However, inadequate knowledge regarding dose calculation was revealed. In addition, specialists' reluctance to use articaine infiltration instead of the block anesthesia was evident in the current population. Further studies, with larger sample size are encouraged.
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Affiliation(s)
- Thikrayat Bani-Hani
- Division of Pediatric Dentistry, Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Rami Al-Fodeh
- Department of Prosthodontics, Jordan University of Science and Technology, Irbid, Jordan
| | - Abedelmalek Tabnjh
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 600077, India
- Department of Applied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Rona Leith
- Department of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland
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Krishna S, Bhaskaran R, Kumar SP, Krishnan M. Comparison of the Efficacy Between Articaine and Lignocaine in Simultaneous Bilateral Orthodontic Maxillary Premolar Extractions: A Split-Mouth Comparative Study. Cureus 2023; 15:e50078. [PMID: 38192927 PMCID: PMC10771934 DOI: 10.7759/cureus.50078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction Local anesthesia plays a crucial role in ensuring patient comfort during orthodontic extractions. Among the various local anesthetic agents commonly used in the field of oral surgery are articaine and lidocaine, which differ in their duration of action and pain effectiveness (pain control) during surgical procedures. This article aimed to analyze the characteristics of 2% lignocaine with 1:80000 adrenaline and 4% articaine with 1:100000 adrenaline regarding duration of action and pain control in patients undergoing bilateral orthodontic maxillary premolar extractions. Materials and methods A split-mouth comparative study was conducted at Saveetha Dental College and Hospitals, Chennai, for which 50 patients of age less than 30 years and who required bilateral orthodontic premolar extractions were selected. Approximately 4% articaine hydrochloride solution was administered on one side, and 2% lignocaine hydrochloride was administered on the contralateral side. Palatal infiltration was not given in the articaine group. The degree of extraction difficulty was similar in both groups, with no discernible variation. In each patient, the duration of anesthesia and pain control were assessed. The IBM Statistical Package for Social Sciences (SPSS version 24.0, IBM SPSS Statistics for Windows, Armonk, NY) was used to perform the student's paired t-test for detecting the difference in outcome parameters between the two groups. Results Upon comparing both groups, it was concluded that the articaine group had a longer mean anesthetic duration of action of 217 minutes, whereas for the lignocaine group, it was 169 minutes, and greater pain reduction was present with the articaine group. The articaine group exhibited less pain (superior pain control) with a mean visual analogue scale (VAS) score of 1.07 compared to that of the lignocaine group with a mean VAS score of 1.53 during orthodontic premolar extractions. Both the results were statistically significant (P=0.001). Conclusion This split-mouth comparative study concludes that articaine is a more effective local anesthetic in terms of duration of action and pain reduction than that of lignocaine, and it can be used as a local anesthetic of choice for orthodontic maxillary premolar extractions.
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Affiliation(s)
- Sai Krishna
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Rajprakash Bhaskaran
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Santhosh P Kumar
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Murugesan Krishnan
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Vasović DD, Karamarković M, Stojičić M, Jovanović M, Savić Vujović K, Rašić D, Colić M, Musić N. Buffered Versus Nonbuffered Local Anesthetics and Local Pain Scores in Upper Eyelid Blepharoplasty: Randomized Controlled Trial. Ophthalmic Plast Reconstr Surg 2023; 39:602-605. [PMID: 37338328 DOI: 10.1097/iop.0000000000002442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
PURPOSE This split-face study aimed to see whether different types of local anesthetics or their buffered/nonbuffered combinations produce lower pain scores in upper eyelid blepharoplasty. METHODS The study involved 288 patients, randomly divided into 9 groups: 1) 2% lidocaine with epinephrine-Lid + Epi; 2) 2% lidocaine with epinephrine and 0.5% bupivacaine (1:1)-Lid + Epi + Bupi; 3) 2% lidocaine with 0.5% bupivacaine (1:1)-Lid + Bupi; 4) 0.5% bupivacaine-Bupi; 5) 2% lidocaine-Lid; 6) 4% articaine hydrochloride with epinephrine-Art + Epi; 7) buffered 2% lidocaine/epinephrine with sodium bicarbonate (SB) in a 3:1 ratio-Lid + Epi + SB; 8) buffered 2% lidocaine with SB in a 3:1 ratio-Lid + SB; 9) buffered 4% articaine hydrochloride/epinephrine with SB in a 3:1 ratio-Art + Epi + SB. Following the injection of the first eyelid and a 5-minute period of soft pressure on the injection site, patients were asked to rate their pain level on the Wong-Baker Face Pain Rating Visual Analogue Scale. Rating of the pain level was repeated 15 and 30 minutes following anesthetic administration. RESULTS The lowest pain scores at the first time point were observed in Lid + SB when compared with all of the other groups ( p < 0.05). At the final time point, significantly lower scores were also observed in Lid + SB, Lid + Epi + SB, and Art + Epi + SB when compared with the Lid + Epi group ( p < 0.05). CONCLUSION These findings could help surgeons select an appropriate combination of local anesthetics, particularly in patients with lower pain threshold and tolerance because buffered combinations of local anesthetics produce significantly lower pain scores compared with nonbuffered solutions.
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Affiliation(s)
- Dolika D Vasović
- Eye Hospital University Clinical Centre of Serbia, Belgrade, Serbia
| | - Miodrag Karamarković
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Milan Stojičić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Jovanović
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Katarina Savić Vujović
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Belgrade, Serbia
| | - Dejan Rašić
- Eye Hospital University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Grubbs H, Strasswimmer J. How We Do It: Articaine for Infiltrative Anesthesia. Dermatol Surg 2023; 49:1043-1044. [PMID: 37682917 DOI: 10.1097/dss.0000000000003909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Affiliation(s)
- Hailey Grubbs
- Dermatology Resident, Dermatology Department, Broward Health Medical Center, Fort Lauderdale, Florida
| | - John Strasswimmer
- Clinical Professor of Dermatology and Research Professor of Biochemistry, Departments of Dermatology and Biochemistry, Florida Atlantic University College of Medicine, Boca Raton, Florida
- Strasswimmer Mohs Surgery, Delray Beach, Florida
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Gheisari R, Saatchi M, Estakhri F, Vossoughi M, Bazaei M, Khosravani Z. Effect of local anesthetics on renal function: An animal study in Iran. Dent Res J (Isfahan) 2023; 20:106. [PMID: 38020254 PMCID: PMC10680069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/26/2023] [Accepted: 09/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background Although most of the metabolism of local anesthetics (LAs) takes place in the liver, no study has investigated the effect of these anesthetics on the kidney function of single-kidney humans or animals. The present study was conducted to examine the effect of LAs on renal function in single-kidney rats. Materials and Methods The present experimental animal study with two control groups was done in an animal laboratory. Forty-two rats were randomly assigned to seven groups of six rats, including two control groups and five experimental groups. The experimental groups underwent intraperitoneal anesthesia with 2% lidocaine, 2% lidocaine with 1:80,000 epinephrine, 4% articaine, 3% prilocaine with 0.03 IU Felypressin, and 3% mepivacaine, respectively. Unilateral nephrectomy was done. After 24 h, the rats' blood urea nitrogen (BUN), serum creatinine (Cr), and blood specific gravity (BSG) were measured. A standard dose of anesthetics was injected into the peritoneum for 4 days afterward. Then, these indices were measured again 24 h after the last injection. Data were analyzed using IBM SPSS (version 21.0). One-way analysis of variance, Tukey's honestly significant difference post hoc, and paired t-tests were used for statistical analysis. P < 0.05 was considered statistically significant. Results The results indicated significant differences among groups in the rats' BUN and serum Cr 24 h after nephrectomy (P < 0.05). However, there were no significant differences in BUN, BSG, and Cr among groups after the interventions. Conclusion LAs did not affect renal function in single-kidney rats. Therefore, dentists can use the anesthetics in single-kidney people.
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Affiliation(s)
| | - Masoud Saatchi
- Department of Endodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mehrdad Vossoughi
- Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Bazaei
- Department of Veterinary Sciences, Faculty of Veterinary Sciences, Kazerun Branch, Islamic Azad University, Kazerun, Iran
| | - Zahra Khosravani
- Postgraduate Student, Dental Students’ Research Committee, Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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12
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Afkhami F, Rostami G, Peters OA, Kamalian F. Pulpal anesthesia of maxillary first molars using 4% articaine infiltration in patients with symptomatic irreversible pulpitis: a randomized controlled clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-05025-y. [PMID: 37243822 DOI: 10.1007/s00784-023-05025-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 04/15/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVES This study aimed to compare the anesthetic efficacy of 1.8 mL (one cartridge) and 3.6 mL (two cartridges) buccal infiltration and buccal plus palatal infiltration of 4% articaine in maxillary first molar teeth with symptomatic irreversible pulpitis. MATERIALS AND METHODS This randomized single-blind clinical trial was conducted on 45 patients with symptomatic irreversible pulpitis of maxillary first molars (Trial Registration No: IRCT2015011020238N2_2015). The patients were randomly divided into three groups (n = 15) for buccal infiltration of 1.8 mL articaine plus 1:100,000 epinephrine (group 1), buccal infiltration of 3.6 mL articaine (group 2), and buccal infiltration of 1.8 mL articaine plus palatal infiltration of 0.5 mL articaine (group 3). The pain intensity was measured by the Heft-Parker visual analog scale (VAS) during injection and during access cavity preparation. No pain or mild pain during treatment was considered as successful anesthesia. Data were analyzed by the Tukey's post hoc test. RESULTS The three groups had a significant difference in frequency of the perceived pain during injection (P = 0.01). A higher volume of 4% articaine and injection of articaine in both buccal and palatal sides provided a significantly higher anesthesia success rate (P = 0.049 and P < 0.01, respectively). The highest success rate was recorded in group 3 (93.33%) followed by group 2 (80%) and then group 1 (53.33%). CONCLUSIONS Increasing the administered volume of 4% articaine with 1:100,000 epinephrine and addition of palatal infiltration to buccal infiltration of articaine can significantly increase the success of anesthesia in maxillary first molars with symptomatic irreversible pulpitis. CLINICAL RELEVANCE Achieving deep anesthesia in teeth with irreversible pulpitis is a critical parameter in management of patients who are in urgent need of root canal treatments.
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Affiliation(s)
- Farzaneh Afkhami
- School of Dentistry, Tehran University of Medical Sciences, Mahan St, Tehran, 1894787545, Iran.
- School of Dentistry, The University of Queensland, Brisbane, Australia.
| | | | - Ove A Peters
- School of Dentistry, The University of Queensland, Brisbane, Australia
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13
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Gonzalez VH, Wirta DL, Uram M, Schupp A, Widmann M, Novack GD. Two Randomized, Double-masked, Placebo-controlled Studies of the Local Anesthetic Effect of Articaine Ophthalmic Solution. Clin Ophthalmol 2023; 17:1357-1365. [PMID: 37192994 PMCID: PMC10183183 DOI: 10.2147/opth.s409241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/04/2023] [Indexed: 05/18/2023] Open
Abstract
Background We wanted to develop a new topical ocular anesthetic with good bioavailability in anterior segment tissues. Given concerns about contamination and sterility in multi-dose products, we selected a unit-dose, nonpreserved presentation of AG-920 (articaine ophthalmic solution) in blow-fill-seal containers (similar to currently marketed pharmacological therapies for dry eye disease). Methods Consistent with US Food and Drug Administration guidance, two pivotal, Phase 3, randomized, placebo-controlled, double-masked, parallel design studies conducted at two US private practices in 240 healthy subjects. A single dose of AG-920 or identical looking placebo into one (study) eye (2 drops 30 s apart). Subjects underwent a conjunctival pinch procedure and assessment of the pain associated with the pinch. The main outcome measure was the proportion of subjects with rating of "No pain at 5 minutes". Results AG-920 provided a rapid onset of local anesthesia (less than one minute) with clinically and statistically significantly greater effect in AG-920 (68% and 83%) than placebo (3% and 18% for Study 1 and Study 2, respectively, P<0.0001). The most frequent adverse event was instillation site pain (27% vs 3%) followed by conjunctival hyperemia (probably related to the pinch, 9% vs 10%) in the AG-920 and placebo groups, respectively. Conclusion AG-920 was found to be have a rapid onset and useful duration of local anesthesia with no major safety issues, and may be useful for the eye-care professional. Registered with clinicaltrials.gov as NCT04513652 and NCT04829344.
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Affiliation(s)
| | | | | | | | | | - Gary D Novack
- PharmaLogic Development, Inc., San Rafael, CA, USA
- Department of Ophthalmology & Vision Science, University of California, Davis, School of Medicine, Sacramento, CA, USA
- Correspondence: Gary D Novack, PharmaLogic Development, Inc., 17 Bridgegate Drive, San Rafael, CA, 94903, USA, Tel +1 415 472-2181, Email
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14
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Luo W, Zheng K, Kuang H, Li Z, Wang J, Mei J. The potential of articaine as new generation of local anesthesia in dental clinics: A review. Medicine (Baltimore) 2022; 101:e32089. [PMID: 36482533 PMCID: PMC9726299 DOI: 10.1097/md.0000000000032089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
As a new drug for local dental anesthesia, articaine has become popular in the clinic in recent years. In this review, we describe the development of articaine, explain its mechanism of action, compare its efficacy with that of other commonly used local anesthetics in dental treatment, and summarize the application of articaine in special populations. In conclusion, the anesthetic efficacy of articaine in clinical dental treatment is better than that of lidocaine, and its safety is not statistically different from that of lidocaine. In particular, articaine has several advantages and can be selected flexibly for clinical use. Atecaine has great potential for wide application in dental clinics in the near future.
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Affiliation(s)
- Wen Luo
- Department of Stomatology, the First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Kaiyue Zheng
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Huifang Kuang
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Zhixin Li
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Jinrong Wang
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Jie Mei
- School of Stomatology, Hainan Medical University, Haikou, China
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15
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Articaine: dental practitioner use, basis of perception and evidence-based dentistry—a cross-sectional study. BDJ Open 2022; 8:20. [PMID: 35788125 PMCID: PMC9253308 DOI: 10.1038/s41405-022-00113-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 12/04/2022] Open
Abstract
Background Limited data exist on dental practitioner use and perceptions of articaine. This study is a cross-sectional survey of dental practitioners from January, 2021 to ascertain the extent of their use of the dental local anaesthetic, articaine, the basis of their perceptions about articaine and whether current practices are in line with recent evidence regarding articaine safety and efficacy. Method An anonymous survey was designed using the SAP Qualtrics Core XM software platform and a survey link was disseminated from December 2020 to January 2021 via social media. The survey was designed as a five minute, anonymous, online questionnaire including a plain language information sheet, request for participant consent and 14 questions. Data were entered onto a Microsoft™ Excel spreadsheet and analysed qualitatively, isolating the answers into recurrent themes. Results Sixty percent of the surveyed dental practitioner used articaine as their preferred dental anaesthetic. Twenty-three percent of the dental practitioner surveyed used articaine for all of their dental procedures including inferior alveolar nerve blocks, while 40% of respondents used articaine for all their dental procedures except inferior alveolar nerve blocks. The predominant basis of dental practitioner uses and perception of articaine were their countries dental guidelines. Conclusion Despite the latest findings that articaine is as safe and more efficacious as lidocaine for all routine dental treatment, 40% of survey respondents avoided articaine use for inferior alveolar blocks. Our study recognises a discrepancy between reported clinical practice and current research evidence. Further research and clarifications are needed to achieve ubiquitous practice of evidence-based dentistry.
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Habib MFOM, Tarek S, Teama SME, Ezzat K, El Boghdadi RM, Marzouk A, Fouda MY, Gawdat SI, Bedier MM, Amin SAW. Inferior Alveolar Nerve Block Success of 2% Mepivacaine versus 4% Articaine in Patients with Symptomatic Irreversible Pulpitis in Mandibular Molars: A Randomized Double-Blind Single-Centre Clinical Trial. Int Endod J 2022; 55:1177-1189. [PMID: 35947082 DOI: 10.1111/iej.13810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/27/2022]
Abstract
AIM To assess inferior alveolar nerve block (IANB) success of 2% mepivacaine (Scandonest 2%, Septodont, France) and 4% articaine (Septanest 4%, Septodont) in patients with symptomatic irreversible pulpitis (SIP) in mandibular molars during access cavity preparation and instrumentation. METHODOLOGY Three hundred and thirty patients with moderate-to-severe pain in mandibular molars with SIP randomly received either 3.6 mL 2% mepivacaine hydrochloride with 1:100 000 adrenalin or 3.4mL 4% articaine hydrochloride with 1:100 000 adrenalin (n=165). Intraoperative pain (IOP) intensity was assessed during access cavity preparation and canal instrumentation using 11-point numerical rating scale (NRS). Overall success was considered if the patient felt no-to-mild pain without the need of supplemental anaesthesia throughout treatment; the incidence of need for supplemental anaesthesia was also recorded. Data were statistically analyzed using Mann Whitney U and Chi2 (χ2 ) tests. Relative risk (RR) and 95% confidence interval (CI) of anaesthetic failure was calculated. The effect of predisposing factors on outcome variables was assessed using multivariable regression analyses. None of the participants reported any adverse effects. RESULTS Baseline variables were balanced between groups (p>0.05). The IOP intensity during access cavity preparation and canal instrumentation was similar for both groups (p>0.05). IOP intensity was associated with preoperative pain intensity and tooth type (p<0.05). Overall anaesthetic success rate was 35.8% for mepivacaine and 41.2% for articaine (p>0.05) with a relative risk of failure [95%CI] 1.09 [0.92, 1.30]. The need for supplemental anaesthesia occurred 43.6% and 38.2% with mepivacaine and articaine respectively (p>0.05; RR [95%CI]: 1.14 [0.88, 1.48]). Preoperative pain level and age were associated with the need for supplemental anaesthesia. CONCLUSIONS 2% mepivacaine and 4% articaine demonstrate similar IANB success rates for mandibular molars with SIP. Intraoperative pain experience during endodontic treatment can be associated with preoperative pain, tooth type and age.
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Affiliation(s)
- M F O M Habib
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - S Tarek
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - S M E Teama
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - K Ezzat
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - R M El Boghdadi
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - A Marzouk
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - M Y Fouda
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - S I Gawdat
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - M M Bedier
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - S A W Amin
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Verhoeven R, Uram M, Schupp A, Rasmussen S, Widmann M, Novack GD. Early Nonclinical and Clinical Development of AG-920, a Repurposed Topical Ocular Anesthetic. J Ocul Pharmacol Ther 2022; 38:481-488. [DOI: 10.1089/jop.2022.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Martin Uram
- American Genomics, LLC, Little Silver, New Jersey, USA
| | - Audrey Schupp
- CMC Turnkey Solutions, Inc., Lone Tree, Colorado, USA
| | | | | | - Gary D. Novack
- PharmaLogic Development, Inc., San Rafael, California, USA
- Department of Ophthalmology and Visual Science, School of Medicine, University of California, Davis, Davis, California, USA
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BDJ Open 2021 - our most successful year to date. Br Dent J 2022; 232:744-746. [PMID: 35624266 PMCID: PMC9137261 DOI: 10.1038/s41415-022-4197-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This paper aims to provide an update on the previous version published towards the end of last year, titled 'BDJ Open (2019-2020) and the advantages of open access publishing'. In this paper, we will highlight articles published throughout 2021, in order to focus on which areas authors felt were important to publish open access and also which areas have been expanded upon in the journal. Furthermore, this paper will examine how open access publishing in BDJ Open has enabled the continuous process of hypothesis testing to be shared more widely, as well as how publishing protocols and early results open access gives strength to that by allowing earlier opportunity for comment by other researchers, both through the peer review process and through further correspondence to authors directly and to the journal editors who publish their work. Provides an update on the previous 2019-2020 paper by examining articles published in BDJ Open in 2021, to highlight which areas researchers felt were important to publish open access. Highlights the advantages of open access publishing to authors, readers and the scientific community, particularly in light of the ongoing COVID-19 pandemic. Explores how open access publishing in BDJ Open has enabled the continuous process of hypothesis testing to be shared more widely, allowing earlier opportunity for comment by other researchers.
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Comparison of the Effects of Articaine and Lidocaine Anesthetics on Blood Pressure after Maxillary Infiltration Technique: A Triple-Blind Randomized Clinical Trial. Int J Dent 2021; 2021:8894160. [PMID: 34497646 PMCID: PMC8419499 DOI: 10.1155/2021/8894160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background Many dental procedures begin with local anesthesia. Subsequent increase in blood pressure in healthy individuals commonly occurs and may be affected by several factors such as mental and physical stress, painful stimuli, and action of catecholamines present in local anesthetic solutions. The aim of the present study is to compare the effects of 4% articaine with 1 : 100000 epinephrine and 2% lidocaine with 1 : 80000 epinephrine on blood pressure after maxillary infiltration technique. Materials and Methods In this randomized clinical trial, 102 patients were randomly assigned into two groups. One group received 4% articaine with 1 : 100000 epinephrine and the other group received 2% lidocaine with 1 : 80000 epinephrine for local maxillary infiltration. Systolic and diastolic blood pressure of both groups was determined twice: once before anesthetic injection and once 10 minutes after injection. The data were statistically analyzed using descriptive statistics, Shapiro–Wilks test, Levene test, chi-square test, independent t-test, and paired t-test. Results The mean systolic blood pressure after anesthetic injection in the articaine and lidocaine groups was 125.00 ± 5.67 and 123.16 ± 6.417 mmHg, respectively, showing no statistically significant difference (p=0.127). The mean diastolic blood pressure after injection was 85.02 ± 7.331 in the articaine group and 81.35 ± 12.815 mmHg in the lidocaine group. These values show no statistically significant difference (p=0.080). In both groups, the mean systolic and diastolic blood pressures have increased significantly (p < 0.001). Conclusion Articaine can be regarded as a suitable alternative for lidocaine for maxillary local infiltration, as no significant difference was observed between the effects of the two anesthetic solutions on blood pressure.
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