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Testing the Anesthetic Effectiveness of Three Different Dental Local Anesthetics Injected Next to a Lower First Molar

Phase 4
Completed
Conditions
Anesthetic Effectiveness
Interventions
Procedure: Mandibular buccal Infiltration injection
Registration Number
NCT01567839
Lead Sponsor
Ohio State University
Brief Summary

Infiltration (injecting next to the tooth) injections are common in dentistry and a number of studies have shown that articaine anesthetic, when injected next to the tooth as a supplemental injection, works very well following a typical inferior alveolar (lower jaw) nerve block. No study has compared 4% articaine with 1:100,000 epinephrine, 4% prilocaine with 1:200,000 epinephrine, and 4% lidocaine with 1:100,000 epinephrine in mandibular (lower jaw) infiltration injections of the first molar. The purpose of this prospective, randomized, double-blind, crossover study is to compare the degree of anesthesia obtained from the three solutions as a primary infiltration injection next to the mandibular first molar. The investigators also will record the pain of injection and postoperative pain.

Detailed Description

Using a crossover design, 60 adult subjects will receive three injections consisting of a primary mandibular first molar infiltration of 1.8 mL of 4% articaine with 1:100,000 epinephrine, 1.8 mL of 4% prilocaine with 1:200,000 epinephrine, and 1.8 mL of 4% lidocaine with 1:100,000 epinephrine in three separate appointments spaced at least one week apart. With the crossover design, 180 infiltrations will be given for the first molar and each subject will serve as his or her own control. Ninety infiltrations will be administered on the mandibular left side and ninety administered on the mandibular right side. The order of the three injections will be assigned randomly and the dentist and subject will be blinded about which anesthetic the subject is given. The anesthetics used in this study are not experimental. An electric pulp tester will be used to test the lower back teeth (molars and premolars) for anesthesia in 3-minute time intervals for a total of 60 minutes. The pain of injection and postoperative pain will be recorded in a survey. The data will be statistically analyzed.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria
  • between the ages of 18 and 65 years.
  • in good health (ASA classification II or lower).
  • able to provide informed consent.
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Exclusion Criteria
  • allergy to articaine, lidocaine or prilocaine.
  • history of significant medical problems (ASA classification III or greater).
  • depression (taking tri-cyclic antidepressant medications to control).
  • have taken CNS depressants (including alcohol or any analgesic medications) within the last 48 hours prior to testing.
  • lactating or pregnant.
  • inability to give informed consent.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
4% LidocaineMandibular buccal Infiltration injection1.8 mL of 4% lidocaine with 1:100,000 epinephrine
4% ArticaineMandibular buccal Infiltration injection1.8 mL of 4% articaine with 1:100,000 epinephrine
4% PrilocaineMandibular buccal Infiltration injection1.8 mL of 4% prilocaine with 1:200,000 epinephrine
Primary Outcome Measures
NameTimeMethod
Successful Pulpal Anesthesia.60 minutes

Two consecutive 80/80 readings (no patient response) during 60 minutes of testing with an electric pulp tester.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

The Ohio State University College of Dentistry, Postle Hall

🇺🇸

Columbus, Ohio, United States

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