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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65 case reports and 1 case series were included in this reviews of the ophthalmic side effects from dental local anaesthesia. 92 % were transitory the remainder permanent. 25% of the transitory side effects took up to 6 hours to resolve.
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10 studies involving 746 adult patients were included in this review comparing articaine and lidocaine in patients with symptomatic irreversible pulpitis. Articaine was as effective as lidocaine and provided better supplementary infiltration after mandibular block but no other advantages.
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This well conducted and reported trial found that there was no difference between 3% mepivacaine & 2% lidocaine with 1:100,000 epinephrine and 2 cartridges of 2% lidocaine with 1:100,000 epinephrine in terms of injection pain, onset time, and pulpal anesthetic success for the IAN block.
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This Cochrane review included 14 trials of variable quality that could not be combined due to variation in local anaesthetic delivery and outcome measures. So the results from individual studies for pain, bleeding and other adverse effects are uncertain.
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