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The effect of intraosseous local anesthesia of 4% articaine with 1:100,000 epinephrine on pulpal blood flow and pulpal anesthesia of mandibular molars and canines

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Abstract

Objectives

The aim of this study was to determine the effect of intraosseous (IO) anesthesia with 4% articaine and 1:100,000 epinephrine on pulpal blood flow (PBF) and pulpal anesthesia of mandibular first molars and canines in human subjects.

Materials and methods

Ten healthy volunteers with intact mandibular first molar and canine were given an osteocentral technique of IO injection using the Quick Sleeper 5 system and 4% articaine with 1:100,000 epinephrine at distal site of mandibular first molar. The PBF was monitored by a laser Doppler flowmeter (LDF). Pulpal anesthesia was assessed with an electric pulp tester (EPT).

Results

IO injection caused a decrease in PBF in molars from 6.31 ± 3.85 perfusion units (P.U.) before injection to 2.51 ± 2.53 P.U. 1 min after injection (P < 0.001). The percentage reduction in PBF was 60% after 1 min and PBF returned back to the baseline after 45 min. No significant reduction in PBF was observed in the canines (P = 0.212). For pulpal anesthesia in the molars, the mean onset was 2.40 ± 0.84 min and the mean duration was 38 ± 16.19 min. In the canines, there was a decrease in the sensitivity to EPT but complete pulpal anesthesia was not achieved.

Conclusions

IO injection distal to mandibular first molar caused a decrease in PBF and successful pulpal anesthesia in first molar, but not in canine. Both PBF and EPT readings returned to normal, suggesting that pulpal ischemia may not occur.

Clinical relevance

IO anesthesia is safe to use as a primary technique in teeth with normal pulp.

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Acknowledgements

This study was supported by the Faculty of Dentistry, Mahidol University. The authors would like to express gratitude to the Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, for their support and assistance.

Funding

For this study, no funding was received.

Author information

Authors and Affiliations

  1. Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand

    Kadkao Vongsavan, Tshering Samdrup & Praphasri Rirattanapong

  2. Department of Oral Biology, Faculty of Dentistry, Mahidol University, Yothi Road, Bangkok, 10400, Thailand

    Kanittha Kijsamanmith & Noppakun Vongsavan

Authors
  1. Kadkao Vongsavan
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  2. Tshering Samdrup
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  3. Kanittha Kijsamanmith
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  4. Praphasri Rirattanapong
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  5. Noppakun Vongsavan
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Corresponding author

Correspondence to Kanittha Kijsamanmith.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Vongsavan, K., Samdrup, T., Kijsamanmith, K. et al. The effect of intraosseous local anesthesia of 4% articaine with 1:100,000 epinephrine on pulpal blood flow and pulpal anesthesia of mandibular molars and canines. Clin Oral Invest 23, 673–680 (2019). https://doi.org/10.1007/s00784-018-2481-3

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  • DOI: https://doi.org/10.1007/s00784-018-2481-3

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