Articaine Hydrochloride

Effective anesthesia of the mandibular lateral incisor is challenging. This study compared the efficacy of lingual infiltration alone versus combined labial and lingual infiltration using 4% articaine with 1:100,000 epinephrine.

In this prospective, randomized, crossover clinical trial, 50 healthy volunteers received two infiltration techniques: (1) lingual infiltration only (3.6 mL total via two 1.8 mL injections plus a mock buccal injection), and (2) combined labial and lingual infiltration (1.8 mL each; 3.6 mL total plus a mock lingual injection). Anesthetic success was evaluated by: 1) absence of response to maximal electronic pulp tester stimulation, 2) sustained anesthesia defined as no response within 16 minutes lasting 42 minutes, and 3) anesthesia onset time (first of two consecutive no-response readings). Pain during injection was assessed via the 170-mm Heft-Parker visual analog scale (VAS). Statistical tests included McNemar's, Wilcoxon signed-rank, Friedman, and Dunn's test.

The combined technique produced an equal or higher success rate (P ≤ 0.05), significantly greater sustained anesthesia (P < 0.05), and a significantly shorter onset time (P < 0.05) compared with lingual infiltration alone. Labial infiltration was associated with higher pain scores, especially during solution deposition (P < 0.05).

The combination of labial and lingual infiltration with 4% articaine and 1:100,000 epinephrine significantly improves the anesthetic success and duration for the mandibular lateral incisor, although it is associated with increased injection-related pain.

The aim of the present review was to critically evaluate recent studies to determine the optimal combination of anaesthetic technique and agent for achieving effective anaesthesia in molar incisor hypomineralisation (MIH) patients, thereby addressing a significant need in evidence-based clinical practice. The search question was: What is the most effective modality of anaesthesia to reduce hypersensitivity in MIH-affected teeth in children?

A systematic search was conducted using four databases, namely, MEDLINE via PubMed, Science Direct, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL), using a selection of MeSH terms. The "Modified Jadad Scale" and the "Newcastle Ottawa Scale" were used for the methodology assessment of the included studies.

Out of 134 articles identified in the initial search, six articles met all the inclusion criteria. The results showed that intraosseous anaesthesia with 4% articaine demonstrated the highest efficacy.

Achieving complete anaesthesia in teeth affected by MIH enhances comfort for both patients and practitioners, contributing to improved treatment quality. Intraosseous anaesthesia with 4% articaine and epinephrine has proven effective in reducing pain and hypersensitivity in pediatric patients with MIH. However, further studies are needed in this population to draw definitive conclusions.