Background: While local anesthetics are essential drugs in dentistry, risks such as paresthesia are associated with their use. The purpose of this study was to analyze the reported paresthesia cases in the United Kingdom. Methods: Voluntary reports of paresthesia from local anesthetic use between 1998 and 2008 obtained from UK’s Yellow Card Scheme were examined. Statistical significance was tested using the Chi-Square analysis, comparing expected frequencies of paresthesia based on the UK dental anesthetic sales data, to the observed reports of paresthesia. Results: Of the 44 reported cases of paresthesia, 85% of the cases involved the mandible with the lingual nerve being the most often affected. The frequency of observed paresthesia associated with 4% articaine solution, was 5.9 times greater than expected (χ2, p<0.0001). Conclusions: These data suggest that paresthesia after the injection of local anesthetic in dentistry is rare, yet more likely to occur if a 4% solution is used.

Background: While local anesthetics are essential drugs in dentistry, risks such as paresthesia are associated with their use. The purpose of this study was to analyze the reported paresthesia cases in the United Kingdom. Methods: Voluntary reports of paresthesia from local anesthetic use between 1998 and 2008 obtained from UK’s Yellow Card Scheme were examined. Statistical significance was tested using the Chi-Square analysis, comparing expected frequencies of paresthesia based on the UK dental anesthetic sales data, to the observed reports of paresthesia. Results: Of the 44 reported cases of paresthesia, 85% of the cases involved the mandible with the lingual nerve being the most often affected. The frequency of observed paresthesia associated with 4% articaine solution, was 5.9 times greater than expected (χ2, p<0.0001). Conclusions: These data suggest that paresthesia after the injection of local anesthetic in dentistry is rare, yet more likely to occur if a 4% solution is used.

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No description available.

Purpose: To determine possible differences in the pain level and soft tissue anesthesia duration of plain polocaine versus epinephrine-containing articaine and lidocaine during intraoral injections. Methods: Forty-eight subjects received plain polocaine and one epinephrine-containing anesthetic. Injections were randomized according to the first injection a)left or right buccal sulcus and b)epinephrine or not. The second injections were the opposite conditions. Subjects then recorded discomfort on a VAS and the time anesthesia wore off. Result: The second injection’s pain rating was influenced by the first. This carry-over effect makes it impossible to analyze all of the data. An analysis of the first injection showed no significant difference between the three anesthetics. The duration of anesthesia for epinephrine-containing anesthetic was significantly longer than plain polocaine. Conclusion: This pilot study was intended to create a sample size for a pediatric population. However, due to the carry-over effect, future split-mouth studies may not be justified.

O índice de sucesso em anestesia infiltrativa em molar inferior é muito baixo, o que justifica a técnica de bloqueio do nervo alveolar inferior mesmo essa sendo mais dolorida. Recentes estudos demonstraram que a anestesia infiltrativa com articaína apresentou maior índice de sucesso do que com a lidocaína, porém, ainda não foi possível evitar falha anestésica. Para aumentar o índice de sucesso dessa técnica vislumbra-se a utilização da enzima hialuronidase como fator de difusão do anestésico local e aumentar a eficácia clínica. O estudo avaliou se a hialuronidase à 150 UTR injetada imediatamente após a articaína infiltrativa em primeiro molar inferior seria capaz de prolongar a duração da anestesia local (AL) na polpa e na gengiva, reduzir a latência de ação, aumentar o seu índice de sucesso anestésico e se o uso da H aumenta a dor do local. Participaram 28 pacientes ASA I e II que apresentavam necessidade de restauração em 2 primeiros molares inferiores. Estes foram alocados em 2 grupos: (1º) 28 pacientes receberam anestesia com articaína 4% associada à epinefrina em seguida era injetada H 150 UTR/ml. (2º) Idêntico ao primeiro grupo, porém utilizando placebo (solvente da hialuronidase) de forma duplo-cego e boca dividida. A latência e a duração na polpa foram avaliadas com estímulo elétrico na face vestibular do primeiro molar inferior, a cada 2 e 10 min, respectivamente. Para gengiva vestibular, utilizou-se estímulo mecânico (picada). Para análise do índice de dor utilizou-se escala numérica de dor (1 a 5) em 3 tempos analisados. A presença da hialuronidase não melhorou o índice de sucesso, não diminuiu o tempo de latência gengival, não aumentou a duração de ação pulpar nem a gengival e não aumentou os níveis de dor, mas houve diminuição da latência gengival do grupo H 150 se comparado a todos os demais. Nas condições experimentais, esta concentração de H não melhora a eficácia clínica. / The success rate in infiltrative anesthesia in lower molar is very low, which explains the technique of inferior alveolar nerve block even this is more painful. Recent studies have shown that infiltrative anesthesia with articaine had a higher success rate than with lidocaine, however, has not been possible to avoid failure of anesthesia. To increase the success rate of this technique envisages the use of the enzyme hyaluronidase as a factor of local anesthetic spread and increase clinical efficacy. The study evaluated whether the 150 TRU/ml to hyaluronidase injected immediately after articaine infiltration in the first molar would be able to prolong the duration of local anesthesia (LA) in the pulp and gums and reduce latency of action, increase your success rate of anesthetic and the use of H increases the pain site. Participated in 28 ASA I and II patients who had need of restoration in two mandibular first molars. These were divided into 2 groups: (1) 28 patients received anesthesia with 4% articaine associated with epinephrine was then injected H 150 TRU/ml. (2) Same as the first group, but using placebo (hyaluronidase solvent) in a double-blind, split-mouth. The latency and duration of the pulp electrical stimulation were evaluated on the buccal of the mandibular first molar, every 2 and 10 min, respectively. For vestibular gingiva, we used mechanical stimulation (pinprick). To analyze the level of pain was used numeric pain scale (1-5) at 3 times analyzed. The presence of hyaluronidase didnt improve the success rate was not reduced latency time gum didnt increase the duration of action or the pulp and gum didnt increase levels of pain, but there was reduced latency gum group compared to H 150 all others. Under the experimental conditions, this concentration of H not improved clinical efficacy.

Orientadores: José Ranali, Rogério Heládio Lopes Motta / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-17T06:40:44Z (GMT). No. of bitstreams: 1 Pereira_LeandroAugustoPinto_M.pdf: 2346119 bytes, checksum: 1ae13762ef6c594e6efc8221c85c9630 (MD5) Previous issue date: 2010 / Resumo: Introdução: A rápida absorção dos vasoconstritores administrados pela anestesia intraóssea pode aumentar a frequência cardíaca. As soluções com baixa concentração de epinefrina (1:200.000) não foram totalmente estudadas para injeção intraóssea. Método: Este estudo prospectivo, randomizado, duplo-cego comparou os efeitos cardiovasculares e a eficácia anestésica de 0.9mL de Articaína 4% com epinefrina 1:100.000 (EPI100) ou Articaína 4% com epinefrina 1:200.000 (EPI200). Ambas as soluções foram injetadas intraóssea para o tratamento endodôntico de molares inferiores com pulpite irreversível sintomática em 60 pacientes. Os parâmetros cardiovasculares avaliados foram, frequência cardíaca, pressão arterial não invasiva diastólica e sistólica, oximetria de pulso e eletrocardiograma durante todo o tratamento endodôntico. O sucesso anestésico e a dor durante a anestesia foram avaliados pela ausência de dor durante o tratamento e por escala visual analógica. Resultados: O tempo médio para realização de todo o procedimento foi de 90.4±18.6 minutos. Ambas soluções proporcionaram um alto índice de eficácia anestésica (96.8% e 93.1%, respectivamente para EPI100 e EPI200) para a realização do tratamento endodôntico em sessão única sem dor. Não houve diferença significante (p>0.05) nos efeitos cardiovasculares entre as soluções. Conclusões: Soluções anestésicas com concentração baixa de epinefrina (1:200.000) associada a baixa velocidade de injeção (0.45mL/min), devem ser a primeira escolha para a utilização com a técnica intraóssea no tratamento de molares inferiores com pulpite irreversível sintomática. / Abstract: Introduction: The fast absorption of adrenergic vasoconstrictors delivered by intraosseous anesthesia (IO) may increase the heart rate. Anesthetic solutions with lower concentration of epinephrine (1:200.000) have not been fully studied for IO injection. Methods: This prospective, randomized, double-blind study compared the cardiovascular effects and the anesthetic efficacy of 0.9 mL of 4% articaine with 1:100.000 epinephrine (EPI100) or 4% articaine with 1:200.000 epinephrine (EPI200). Both solutions were intraosseously injected for endodontic treatment of mandibular molars with symptomatic irreversible pulpitis in 60 patients. The cardiovascular parameters evaluated were heart rate, non-invasive diastolic/systolic blood pressure, pulse oximetry and electrocardiogram throughout the endodontic treatment. The anesthetic success and pain during anesthesia were evaluated by absence of pain during the endodontic treatment and by visual analogue scale. Results: The average time to complete the whole procedure was 90.4±18.6 minutes. Both solutions provided high anesthetic efficacy (96.8% and 93.1%, respectively for EPI100 and EPI200) for painless single-visit endodontic treatment. There were no significant differences (p>0.05) in cardiovascular effects between the solutions. Conclusions: Epinephrine in low concentration (1:200.000) along with slow speed of injection (0.45 mL/min), should be the first choice for intraosseous technique in endodontic treatment of mandibular molars with symptomatic irreversible pulpitis. / Mestrado / Farmacologia, Anestesiologia e Terapeutica / Mestre em Odontologia

O índice de sucesso em anestesia infiltrativa em molar inferior é muito baixo, o que justifica a técnica de bloqueio do nervo alveolar inferior mesmo essa sendo mais dolorida. Recentes estudos demonstraram que a anestesia infiltrativa com articaína apresentou maior índice de sucesso do que com a lidocaína, porém, ainda não foi possível evitar falha anestésica. Para aumentar o índice de sucesso dessa técnica vislumbra-se a utilização da enzima hialuronidase como fator de difusão do anestésico local e aumentar a eficácia clínica. O estudo avaliou se a hialuronidase à 150 UTR injetada imediatamente após a articaína infiltrativa em primeiro molar inferior seria capaz de prolongar a duração da anestesia local (AL) na polpa e na gengiva, reduzir a latência de ação, aumentar o seu índice de sucesso anestésico e se o uso da H aumenta a dor do local. Participaram 28 pacientes ASA I e II que apresentavam necessidade de restauração em 2 primeiros molares inferiores. Estes foram alocados em 2 grupos: (1º) 28 pacientes receberam anestesia com articaína 4% associada à epinefrina em seguida era injetada H 150 UTR/ml. (2º) Idêntico ao primeiro grupo, porém utilizando placebo (solvente da hialuronidase) de forma duplo-cego e boca dividida. A latência e a duração na polpa foram avaliadas com estímulo elétrico na face vestibular do primeiro molar inferior, a cada 2 e 10 min, respectivamente. Para gengiva vestibular, utilizou-se estímulo mecânico (picada). Para análise do índice de dor utilizou-se escala numérica de dor (1 a 5) em 3 tempos analisados. A presença da hialuronidase não melhorou o índice de sucesso, não diminuiu o tempo de latência gengival, não aumentou a duração de ação pulpar nem a gengival e não aumentou os níveis de dor, mas houve diminuição da latência gengival do grupo H 150 se comparado a todos os demais. Nas condições experimentais, esta concentração de H não melhora a eficácia clínica. / The success rate in infiltrative anesthesia in lower molar is very low, which explains the technique of inferior alveolar nerve block even this is more painful. Recent studies have shown that infiltrative anesthesia with articaine had a higher success rate than with lidocaine, however, has not been possible to avoid failure of anesthesia. To increase the success rate of this technique envisages the use of the enzyme hyaluronidase as a factor of local anesthetic spread and increase clinical efficacy. The study evaluated whether the 150 TRU/ml to hyaluronidase injected immediately after articaine infiltration in the first molar would be able to prolong the duration of local anesthesia (LA) in the pulp and gums and reduce latency of action, increase your success rate of anesthetic and the use of H increases the pain site. Participated in 28 ASA I and II patients who had need of restoration in two mandibular first molars. These were divided into 2 groups: (1) 28 patients received anesthesia with 4% articaine associated with epinephrine was then injected H 150 TRU/ml. (2) Same as the first group, but using placebo (hyaluronidase solvent) in a double-blind, split-mouth. The latency and duration of the pulp electrical stimulation were evaluated on the buccal of the mandibular first molar, every 2 and 10 min, respectively. For vestibular gingiva, we used mechanical stimulation (pinprick). To analyze the level of pain was used numeric pain scale (1-5) at 3 times analyzed. The presence of hyaluronidase didnt improve the success rate was not reduced latency time gum didnt increase the duration of action or the pulp and gum didnt increase levels of pain, but there was reduced latency gum group compared to H 150 all others. Under the experimental conditions, this concentration of H not improved clinical efficacy.

No description available.

No description available.