Small study finds limited benefit for lavage to supplement local anesthetic treatment for treatment of temporomandibular disorders


It has been estimates that 20% to 30% of the adult population will experience temporomandibular joint dysfunction. The aim of this study was to assess the short-term efficacy of two treatments for patients with permanently displaced discs and temporomandibular disorder (TMD) pain. Adult patients( ≥ 18)  with TMD  pain and disk displacement without reduction (DDwoR)  [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…]

Side effects of local anaesthetics


Local anaesthetic use is widespread in dentistry and while lidocaine has been in use for more than 50 years an increasing number of agents are now available. The aim of this study was to analyze adverse drug reactions (ADRs) associated with local anesthetics (LAs) and to characterize the safety profile of LAs in clinical application. [read the full story…]

Evidence suggests that 4% articaine provides superior pulpal anaesthesia to 2% lidocaine

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The ability to provide pain- free dentistry is important  and the American Dental Association Center for Evidence-Based Dentistry (ADA-EBD)has just published this critical summary of  a 2011 systematic review by Brandt et al . The review compares the efffecacy  of  two local anaesthetics ( 4% articaine and 2% lidocaine)   in providing successful pulpal anaesthesia. The [read the full story…]

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


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…]

Increasing the pH of lidocaine solution decreases pain on injection and improves patient comfort and satisfaction

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This is a critical appraisal of a Cochrane review first published in December 2010.  The appraisal was prepared under the auspices of the American Dental Associations Centre for Evidence-based Dentistry The objective of the Cochrane review was to determine if adjusting the pH of lidocaine had any effect on pain resulting from non-intravascular injections in [read the full story…]

Adding mannitol improved the effectiveness of local anaesthesia


Modern local anaesthetics have transformed the practice of dentistry. However  a proportion of  injections fail to achieve pulpal anaesthesia.   This trial set out to find if  the addition of mannitol to lidocaine with epinephrine improved its efficacy. Forty patients were randomised to receive  an inferior alveolar nerve (IAN) block  in 3 separate appointments spaced at [read the full story…]

4% articaine and 2% lidocaine with epinephrine have similar effectiveness in achieving anaesthesia in maxillary teeth

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The aim of the study was to compare the anaesthetic efficacy of buccal infiltrations of 4% articaine with epinephrine (1:100,000) and 2% lidocaine with epinephrine (1:80,000) in achieving anaesthesia in maxillary permanent teeth with irreversible pulpitis. Patients aged 16 years and over who presenting with irreversible pulpitis in one tooth and an asymptomatic vital tooth [read the full story…]

Preoperative ibuprofen and acetaminophen did not improve inferior alveolar nerve anaesthesia success in patients with pulpitis.

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The inferior alveolar nerve block (IANB)  does not always result in successful pulpal anaesthesia with studies noting failure rates between  44% and 81%.  Previous studies have suggested that preoperative medication might increase the success rate of the IANB.  The aim of this study was to determine the effect of the administration of the combination of [read the full story…]