Abstract
Objectives: To compare the clinical anesthetic efficacy of 0.5% bupivacaine and 4% articaine (both with 1:200.000 adrenaline) for anterior maxillary infiltration in healthy volunteers. Material and methods: A triple-blind split-mouth randomized clinical trial was carried out in 20 volunteers. A supraperiosteal buccal injection of 0.9 ml of either solution at the apex of the lateral incisor was done in 2 appointments separated 2 weeks apart. The following outcome variables were measured: latency time, anesthetic efficacy (dental pulp, keratinized gingiva, alveolar mucosa and upper lip mucosa and tissue) and the duration of anesthetic effect. Hemodynamic parameters were monitored during the procedure. Results: Latency time recorded was similar for both anesthetic solutions (p>0.05). No statistically significant differences were found in terms of anesthetic efficacy for dental pulp, keratinized gingiva or alveolar mucosa. Articaine had a significant higher proportion of successful anesthesia at 10 minutes after infiltration in lip mucosa and lip skin (p=0.039). The duration of anesthesia was 336 minutes for bupivacaine and 167 minutes for articaine. (p<0.001). No significant hemodynamic alterations were noted during the procedure. Conclusions: Articaine and bupivacaine exhibited similar anesthetic efficacy for maxillary infiltrations. The duration of anesthesia was longer with the bupivacaine solution, but lip anesthesia was better with articaine. Key words:Articaine, bupivacaine, maxillary, infiltrative anesthesia, long-acting anesthetics.
Highlights
Bupivacaine is a long-acting local anesthetic that has been marketed for dental use since 1971
As well as in pulpal anesthesia, bupivacaine showed a greater anesthetic efficacy compared with articaine, from minute 15
Latency time, anesthetic efficacy and duration of anesthesia are the main parameters studied in other reports that use a similar study design
Summary
Bupivacaine is a long-acting local anesthetic that has been marketed for dental use since 1971. Articaine was synthesized in 1969, but it was not until 1976 that it would be introduced for clinical dentistry It was first marketed in Germany and subsequently throughout Europe and Canada, and in 2000, in the United States. It has some unique chemical characteristics: it is the only amide local anesthetic that contains a thiophene ring and no aromatic ring. Few studies comparing bupivacaine and articaine have been published, the present study being the first clinical trial comparing these two anesthetics for maxillary infiltrations. The aim of this work was to compare the clinical anesthetic efficacy of 0.5% bupivacaine and 4% articaine, both with 1:200.000 adrenaline for maxillary infiltrations. A secondary objective was to detect any hemodynamic alterations after the anesthetic injection
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