Articaine or Lidocaine for third molar removal?

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This review of anaesthetic efficiency of articaine for lower third molar extraction included 9 RCTs ( 493 patients -770 lower molars). The findings suggest that 4% articaine with 1:100,000 epinephrine possesses superior anaesthetic efficiency relative to lidocaine.

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Inferior alveolar nerve block: can NSAIDs improve anaesthetic success?

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This review of the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) as premedication on the success of inferior alveolar nerve block includes 13 RCTs suggesting NSAIDs have a positive impact on success.

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Inferior Alveolar Nerve Block: improving anaesthetic success in patients with irreversible pulpitis

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This network meta-analysis of oral premedication to improve anaesthetic success of inferior alveolar nerve block in patients with irreversible pulpitis suggest that that oral premedication with dexamethasone, NSAIDs and Tramadol increases the success rate.

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Buffering local anaesthetics to reduce dental injection pain?

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14 RCTs were included in this review of the effect of buffering local anaesthetics in reducing infiltration pain and anaesthesia onset time in dentistry. While slight reductions in onset time was seen in inflamed tissues and for IAN block these were not considered to be clinically significant. However the overall quality of the evidence was low.

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Lidocaine: trial suggests that buffering may not improve success of inferior alveolar nerve block

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A 2010 Cochrane review that was not able to include any dental studies did find that buffering lidocaine decreased pain on injection and augmented patient comfort and satisfaction. This new dental trial included 80 patients with symptomatic irreversible pulpitis but found no significant difference with success rates with buffered lidocaine.

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Small study found that pre-operative ibuprofen improved efficacy of inferior alveolar nerve blocks

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Inferior alveolar nerve block (IANB) is a routine technique for achieving regional anaesthesia. However, it is not always successful, with inflammation being a potential cause.  The aim of this study was to evaluate the effect of preoperative oral ibuprofen (IBU) on the success of inferior alveolar nerve blocks (IANBs) with mepivacaine containing 1: 100 000 epinephrine for [read the full story…]

Trail suggests rapid injection technique for inferior alveolar nerve block was more uncomfortable but more effective

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The aim of this study was to compare both the effectiveness of the anaesthesia and the pain with deposition between fast and slow inferior alveolar nerve block (IANB) injection techniques. Patients attending a dental emergency department and requiring endodontic management were randomised to receive either fast (n=30) or slow (n=30) IANB injections using 3.6 mL [read the full story…]

Articaine had slightly better local anaesthesia success than lignocaine when used as buccal infiltration for posterior mandibular teeth in children

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The aim of this study was to compare the efficacy of articaine 4% with 1:100 000 adrenaline and lignocaine 2% with 1:80 000 adrenaline, delivered either as an inferior alveolar nerve block (IANB) or buccal infiltration (BI) for routine restorative procedures in mandibular posterior teeth among children. What did they do Children in need of  [read the full story…]

Supplementary injections to increase numbers of patients receiving pain-free dental treatment

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Unfortunately for patients  with irreversible pulpitis inferior alveolar nerve block (IANB) is not always successful in achieving satisfactory levels of anaesthesia. The aim of this study was to compare the efficacy of supplementary repeat inferior alveolar nerve block with 2% lidocaine and epinephrine, buccal infiltration with 4% articaine with epinephrine, intraligamentary injection, or intraosseous injection [read the full story…]