ORIGINAL ARTICLE   

Minerva Dental and Oral Science 2023 February;72(1):37-44

DOI: 10.23736/S2724-6329.22.04720-9

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Comparative study of the anaesthetic efficacy of 4% articaine versus 2% mepivacaine in mandibular third molar germectomy using different anaesthetic techniques: a split-mouth clinical trial

Dardo MENDITTI ¹, Mariarosaria BOCCELLINO ², Ludovica NUCCI ¹, Antonino P. RIBEIRO SOBRINHO ³, Andrea MAROTTA ¹, Pasquale ANGRISANI ¹, Stefania CANTORE ⁴ ✉, Marco MENDITTI ¹, Antonio VITIELLO ⁴, Marina DI DOMENICO ^{2, 6}, Barbara RINALDI ⁷, Alfredo DE ROSA ¹

¹ Multidisciplinary Department of Medical-Surgical and Dental Specialties, Luigi Vanvitelli University of Campania, Naples, Italy; ² Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy; ³ School of Dentistry, Department of Operative Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil; ⁴ Regional Dental Community Service “Sorriso & Benessere - Ricerca e Clinica”, Bari, Italy; ⁵ Department of Pharmaceutics, Usl Umbria1, Perugia, Italy; ⁶ College of Science and Technology, Department of Biology, Temple University, Philadelphia, PA, USA; ⁷ Department of Experimental Medicine, Luigi Vanvitelli University of Campania, Naples, Italy

BACKGROUND: Currently, one of the most discouraging aspects for many patients undergoing dental procedures is the administration of local anaesthesia. Therefore, there is a constant search for new techniques to avoid the invasive and painful nature of the injection. This study aimed to compare the clinical efficacy of local anaesthetics with articaine 4% or mepivacaine 2% (both with epinephrine 1:100.000), using different anaesthetic techniques to perform germectomy of lower third molars and to assess patients’ feelings and pain during surgery.
METHODS: Totally 50 patients (ranged 11-16 years) who required germectomy of mandibular third molars were recruited. Each patient received local anaesthesia on one side with articaine inoculated with plexus technique while on the other side with mepivacaine using inferior alveolar nerve block technique. The patients’ evaluation was performed on pre and intraoperative tactile-pressure feelings and intraoperative pain with four levels on the Visual Analogue Scale (VAS).
RESULTS: Surgical operations lasted less with more efficient analgesia when articaine was used. The additional intraosseous injection was required mainly in the mepivacaine group intraoperatively. A few patients had tactile-pressure feelings while intraoperative pain sensation was absent in 90% of cases with articaine. Significant differences were found in the cases who reported “absent” and “moderate” VAS values, favoring the use of articaine.
CONCLUSIONS: Articaine injected with a plexus anaesthetic technique seems to be more clinically manageable than mepivacaine for the mandibular third molar germectomy. The discomfort of tactile-pressure feelings and pain experienced was lower using articaine anaesthetic technique used.

KEY WORDS: Anesthetics, local; Mepivacaine; Molar