This review of the most effective anaesthetic solutions for inferior alveolar nerve blocks for mandibular teeth with irreversible pulpitis included 11 RCTs. The findings suggest that mepivacaine with epinephrine performed better than lidocaine with epinephrine but the number of trials is limited and the quality of evidence was very low to moderate.
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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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123 RCTs were included in this Cochrane review of local anaesthetic agents for preventing pain during dental treatment. 14 types of local anaesthetic were included evidence to support the use of one over another was limited so further research is needed to clarify the effectiveness and safety of one local anaesthetic over another.
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This review comparing articaine and lidocaine for local anesthesia use in children only identified 6 low quality studies. Little difference was seen between the two agents.
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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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This Cochrane review of drug interventions for pain during orthodontic treatment including 32 RCTs find that analgesics were effective in reducing pain. However, low quality evidence did not show a difference in effectiveness between systemic NSAIDs compared with paracetamol, or topical NSAIDs compared with local anaesthetic.
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This review of factors affecting fear and anxiety in adult patients undergoing tooth extraction included 16 studies and identified a number of factors associated with anxiety although there are concerns over the quality of the available studies.
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This review of intra-pocket anaesthesia for patients having scaling and root planing included 11 trials and demonstrated a benefit over placebo.
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This Cochrane review found 5 RCTs of pre-op analgesics prior to dental treatment for children under local anaesthetic. The evidence as insufficient to determine a benefit but there may be a benefit prior to orthodontic band placement. Further high quality studies are needed.
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This review of the use of palatal injections for maxillary extractions included 15 studies. While the findings suggest that they may not be needed further high quality studies are needed to confirm the findings.
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