Articaine and mepivacaine efficacy in postoperative analgesia for lower third molar removal: a double-blind, randomized, crossover study.

Author(s): Colombini BL, Modena KC, Calvo AM, Sakai VT, Giglio FP, Dionisio TJ, Trindade AS Jr, Lauris JR, Santos CF

Affiliation(s): Bauru School of Dentistry, Sao Paulo, Brazil.

Publication date & source: 2006-08, Oral Surg Oral Med Oral Pathol Oral Radiol Endod., 102(2):169-74. Epub 2006 Mar 24.

Publication type: Clinical Trial; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

OBJECTIVE: Comparison of the clinical efficacy of 4% articaine in relation to 2% mepivacaine, both with 1:100,000 epinephrine, in the prevention of postoperative pain after lower third molar removal. STUDY DESIGN: Twenty patients underwent removal of bilateral lower third molars under local anesthesia (articaine or mepivacaine) in 2 separate appointments, in a double-blind, randomized, and crossed manner. Objective and subjective parameters were recorded for paired comparison of postoperative courses. RESULTS: Duration of analgesia provided by articaine and mepivacaine was 198.00 +/- 25.86, and 125.40 +/- 13.96 min, respectively (P = .02), whereas the duration of anesthesia was 273.80 +/- 15.94 and 216.85 +/- 20.15 min, respectively (P = .06). Both solutions exerted no important effects upon arterial pressure, heart rate, or oxygen saturation (P > .05). CONCLUSIONS: Articaine provides a longer period of analgesic effect and a tendency for a longer period of anesthesia as compared to mepivacaine. The presence of a vasoconstrictor agent in local anesthetic solutions does not seem to influence hemodynamic parameters during lower third molar removal in healthy subjects.