Clinical use of an epinephrine-reduced (1/400,000) articaine solution in short-time dental routine treatments--a multicenter study

Clin Oral Investig. 2012 Aug;16(4):1289-95. doi: 10.1007/s00784-011-0608-x. Epub 2011 Aug 23.

Abstract

The addition of epinephrine in dental local anaesthesia results in a longer and deeper anaesthesia under almost ischemic conditions. For short-time dental treatments, epinephrine-reduced anaesthetics may offer shorter and more individual anaesthesia with reduced potential side effects. The aim of this study was a clinical evaluation of anaesthetic potency and adverse effects of an epinephrine-reduced articaine formulation in dental patients undergoing short-time routine treatment. In a prospective clinical, not interventional, study between January 2008 and February 2009, 908 patients undergoing short-time dental treatment in five medical centers were anaesthetized with 4% articaine 1:400,000 epinephrine (Ubistesin, 3M/ESPE, Seefeld, Germany). Efficacy and safety in clinical use were evaluated. A follow-up after 1 day was conducted by telephone survey. A mean amount of 1.3-ml anaesthetic solution was needed to achieve a complete or sufficient anaesthesia in 97% (n = 876) of cases. A second injection had to be done in 3.7% (n = 34) before and in 11.9% (n = 108) during treatment. Here, the second injection had to be applied after a mean of 48.6 min. The mean duration of soft tissue anaesthesia after infiltration was 146.6 min, after nerve block 187.7 min. The painful treatment took a mean of 50.2 min and the total treatment time summed up to 68.8 min. In 1.7% cases (n = 15), unwanted side effects were observed. The results indicate that a lower concentration of epinephrine in combination with the 4% articaine solution leads to a high success rate of efficacy. The clinical use of a 4% articaine 1:400,000 epinephrine solution can be stated as safe and effective in short dental routine treatments. Reconsiderations concerning limitations of indication or additional contraindications are not necessary.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Dental / methods*
  • Anesthetics, Local / administration & dosage*
  • Anesthetics, Local / adverse effects
  • Carticaine / administration & dosage*
  • Carticaine / adverse effects
  • Chronic Disease
  • Dental Care / classification
  • Dental Prosthesis
  • Dental Restoration, Permanent
  • Epinephrine / administration & dosage*
  • Epinephrine / adverse effects
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Nerve Block / methods
  • Oral Surgical Procedures
  • Pain Measurement
  • Periodontal Diseases / surgery
  • Prospective Studies
  • Root Canal Therapy
  • Safety
  • Time Factors
  • Vasoconstrictor Agents / administration & dosage*
  • Vasoconstrictor Agents / adverse effects
  • Young Adult

Substances

  • Anesthetics, Local
  • Vasoconstrictor Agents
  • Carticaine
  • Epinephrine