The efficacy of an elevated concentration of lidocaine HCl in impacted lower third molar surgery
Ping Bushara, Kiattavorncharoen Sirichai, Saengsirinavin Chavengkiat, Im Puthavy, Durward Callum, Wongsirichat Natthamet,
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( Ping Bushara ) - Mahidol University Faculty of Dentistry Department of Oral Maxillofacial Surgery
( Kiattavorncharoen Sirichai ) - Mahidol University Faculty of Dentistry Department of Oral Maxillofacial Surgery
( Saengsirinavin Chavengkiat ) - Mahidol University Faculty of Dentistry Research office
( Im Puthavy ) - University of Puthisastra University of Health Sciences Dean of Faculty of Odonto-Stomatology
( Durward Callum ) - University of Puthisastra Department of Dentistry
( Wongsirichat Natthamet ) - Mahidol University Faculty of Dentistry Department of Oral Maxillofacial Surgery
KMID : 0980320150150020069
Abstract
Background: There have been few studies on the effect of an elevated concentration of lidocaine hydrochloride in the surgical removal of an impacted lower third molar. This study aimed to examine the efficacy of 4% lidocaine along with 1:100,000 epinephrine compared to 2% lidocaine along with 1:100,000 epinephrine as inferior alveolar nerve block for the removal of an impacted lower third molar.
Methods: This single-blind study involved 31 healthy patients (mean age: 23 y; range: 19-33 y) with symmetrically impacted lower third molars as observed on panoramic radiographs. Volunteers required 2 surgical interventions by the same surgeon with a 3-week washout period. The volunteers were assigned either 4% lidocaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine as local anesthetic during each operation.
Results: We recorded the time of administration, need for additional anesthetic administration, total volume of anesthetic used. We found that the patient’s preference for either of the 2 types of local anesthetic were significantly different (P < 0.05). However, the extent of pulpal anesthesia, surgical duration, and duration of soft tissue anesthesia were not significantly different.
Conclusions: Our study suggested that inferior alveolar nerve block using 4% lidocaine HCl with 1:100,000 epinephrine as a local anesthetic was clinically more effective than that using 2% lidocaine HCl with 1:100,000 epinephrine; the surgical duration was not affected, and no clinically adverse effects were encountered.
키워드
Efficacy; Electric pulp testing (EPT); Inferior alveolar nerve block (IANB); Lidocaine hydrochloride concentration; Local anesthetic; Third molar; Tooth impaction
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