This review comparing the efficacy and safety of currently available local anaesthetics for lower third molar extraction included 24 RCTs. The findings suggest that 4% articaine was the most effective and lidocaine the safest.
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Colin Levey takes a look at this network meta-analysis of 46 RCTs assessing techniques and drugs for achieving pulpal anaesthesia for the non-surgical endodontic treatment of mandibular molars.
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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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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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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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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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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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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…]
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…]
