Abstract
AimIn paediatric dentistry, epinephrine may contribute to systemic and local side-effects. On the other hand it is necessary to provide good and safe local analgesia. Therefore, an articaine solution with reduced epinephrine concentration was tested in a clinical setting.MethodsIn a non-interventional clinical study, dental treatment was performed in children and adolescents (4–17 years). For local analgesia, articaine 4 % plus epinephrine 1:400,000 was used in the technique chosen by the dentist. Efficacy and tolerance as well as duration of soft tissue analgesia and side-effects were evaluated.Results999 patients (50.5 % male, 49.5 % female) with a mean age of 7.9 (SD 2.34) years were treated. Two hundred seventy six patients (27.6 %) received sedation prior to treatment. The mean treatment time was 15 min (SD 10). In 93.5 % of cases, initial local analgesia was sufficient to perform the planned treatment. In 99 % of cases (n = 989) the planned treatment could be completed. A second injection was necessary in 6.5 % of cases. A mean duration of soft tissue analgesia of 2.19 h (SD 1.01) was seen. Slight side-effects occurred in 3.1 % of subjects.ConclusionsDue to high efficacy, tolerance and safety, the articaine 4 % solution with the reduced epinephrine concentration (1:400,000) was a safe and suitable drug for paediatric routine treatment.
Highlights
Local analgesia, which allows a virtually pain-free treatment, plays a crucial role in paediatric dental practice
An articaine solution with reduced epinephrine concentration was tested in a clinical setting
In a non-interventional clinical study, dental treatment was performed in children and adolescents (4–17 years)
Summary
Local analgesia, which allows a virtually pain-free treatment, plays a crucial role in paediatric dental practice. To avoid the risk of toxicity, especially when treating small children, a body weight-based dosage has to be calculated (Ahmed and Martinez 2009) and the use of a vasoconstrictor is recommended (Lipp et al 1993; Meechan et al 1994; Yagiela 1995). It was shown that adverse reactions occur mainly due to the amount of epinephrine in the analgesic solution (Santos et al 2007). It may lead, especially at sites with increased resorption of the local analgesic or in cases of intravascular injection, to an increased heart rate, ejection volume, blood pressure, Eur Arch Paediatr Dent (2013) 14:89–95 body temperature and blood supply of the skeletal muscles. As result of the longer loss of sensation after dental analgesia—especially in smaller children, self-induced lesions of the soft tissues such as biting of the tongue, the lips and the cheeks may occur (Ram and Amir 2006; Adewumi et al 2008)
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