RESUMO
OBJECTIVE: The aim of this study was to compare the cardiovascular effects and the anesthetic efficacy of intraosseous injections of 4% articaine with 1:100,000 epinephrine (EPI100) or 4% articaine with 1:200,000 epinephrine (EPI200). STUDY DESIGN: In this prospective, randomized, double-blind study, 0.9 mL EPI100 and EPI200 solutions were administered for endodontic treatment of mandibular molars with symptomatic irreversible pulpitis in 60 patients. The anesthetic success and pain during anesthesia were evaluated by visual analog scale. The cardiovascular parameters evaluated were heart rate, diastolic/systolic blood pressure, pulse oximetry, and electrocardiogram changes. RESULTS: Both solutions provided high anesthetic efficacy (96.8% and 93.1% for EPI100 and EPI200, respectively; P > .05), and the cardiovascular parameters showed minimal incidences of significant differences throughout the clinical procedure. CONCLUSIONS: The epinephrine concentration did not affect the efficacy of 4% articaine, and both solutions produced a high success level of pulpal anesthesia. Intraosseous delivery by slow speed of injection did not induce significant clinical changes in cardiovascular parameters.
Assuntos
Anestésicos Locais/administração & dosagem , Carticaína/administração & dosagem , Epinefrina/administração & dosagem , Dente Molar/patologia , Pulpite/terapia , Tratamento do Canal Radicular/métodos , Vasoconstritores/administração & dosagem , Adolescente , Adulto , Pressão Sanguínea/efeitos dos fármacos , Polpa Dentária/efeitos dos fármacos , Método Duplo-Cego , Eletrocardiografia/efeitos dos fármacos , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Injeções/instrumentação , Masculino , Mandíbula , Pessoa de Meia-Idade , Oximetria , Oxigênio/sangue , Medição da Dor , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
Objetivo: Comparar o efeito anestésico da infiltração vestibular maxilar (IVM) e do bloqueio do nervo alveolar superior posterior (BNASP) usando articaína 4% com adrenalina 1:100.000 no desconforto na mucosa palatal averiguado pelo teste pin-prick. Método: Neste estudo randomizado, duplo-cego e cruzado foram selecionados 30 voluntários saudáveis os quais foram submetidos a duas diferentes técnicas anestésicas no vestíbulo da maxila (IVM e BNASP) usando articaína 4% com adrenalina 1:100.000. As injeções foram administradas pelo mesmo operador em duas sessões distintas com intervalo de uma semana entre elas. A anestesia dos tecidos moles do palato foi avaliada pelo teste pin-pick com uma agulha 30G por um operador cego para o tipo de injeção. O desconforto da picada de agulha foi avaliado em quatro momentos utilizando uma escala visual analógica (EVA) de 100 mm. Os dados da EVA foram categorizados como: nenhuma dor a dor leve (0-30 mm) e dor moderada a grave (maior que 30 mm). Os dados foram analisados pelo teste Qui-quadrado e os resultados foram estatisticamente significativos quando p menor que 0,05. Resultados: Apesar de ambas as técnicas puderem insensibilizar o palato, a técnica IVM é menos funcional que a técnica BNASP na insensibilização palatal, não atingindo os mesmos objetivos num mesmo intervalo de tempo. O bloqueio do nervo alveolar superior posterior se mostrou mais efetivo na insensibilização do palato aos 5 minutos (p menor que 0,001) enquanto não houve diferença estatisticamente significante aos 10 minutos (p = 0,87). Conclusões: O BNASP com articaína 4% e adrenalina 1:100.000 foi mais eficaz que o IVM na redução do desconforto pin-prick do tecido mole do palato, aos cinco minutos pós-injeção. Ambas as técnicas foram igualmente eficazes em dez minutos.
Objective: To compare the effect of maxillary buccal infiltration (BI) and posterior superior alveolar nerve block (PSANB) using 4% articaine with 1:100,000 epinephrine on pin-prick discomfort on palatal mucosa. Methods: Thirty healthy subjects participated in this double-blind cross-over study. Each subject received two different maxillary buccal anesthetic techniques with 4% articaine with 1:100.000 epinephrine, namely BI and PSANB. Injections were given by the same operator in different sessions with 1-week interval between them. Anesthesia of palatal soft tissue was assessed by the pin-pick test with a 30G needle by an operator blinded to the type of injection. Discomfort of pin-prick was assessed at four time points using a 100 mm visual analogue scale (VAS). Data from the VAS were categorized as none to mild pain (0-30 mm) and moderate to severe pain (greater than 30 mm). Data were analyzed by Chi-square test and the results were statistically significant when p less than 0.05. Results: Although both techniques could numb the palate, the BI technique appeared less functional that the PSANB technique, not reaching the same goals in the same time interval. PSANB was more effective in stunning the palate at 5 minutes (p less than 0.001) while there was no statistically significant difference between the techniques at 10 minutes (p = 0.87). Conclusions: PSANB with 4% articaine and 1:100,000 epinephrine was more effective than BI in reducing pin-prick discomfort of palatal soft tissue at 5 minutes post-injection. Both techniques were equally effective at 10 minutes.
Assuntos
Humanos , Anestésicos Locais , Carticaína/efeitos adversos , Nervo Maxilar/patologia , Distribuição de Qui-QuadradoRESUMO
The objective of this randomized double-blind investigation was to compare the anesthetic efficacy and injection discomfort of 3 volumes of 2% lidocaine with 1:100,000 epinephrine for maxillary infiltration anesthesia. A total of 25 subjects received 0.6, 0.9, and 1.2 mL of the anesthetic buccal to an upper canine. Test teeth were assessed with electrical stimulation to determine onset and duration of pulpal anesthesia; soft tissue anesthesia and injection discomfort were assessed by pin-prick test and visual analog scale (VAS). Data were analyzed by 2-way analysis of variance (ANOVA), Friedman, and chi-square tests (alpha = 5%). The 1.2 mL dose induced faster onset of pulpal anesthesia, a higher success rate, and a longer duration of soft tissue/pulpal anesthesia than were achieved with the other doses (P < .05). No differences in injection discomfort were observed between treatments. It is concluded that maxillary infiltration anesthesia with lidocaine and epinephrine has a faster onset, a greater success rate, and a longer duration when a volume of 1.2 mL is used than when volumes less than 1.0 mL are used.
Assuntos
Anestesia Dentária/métodos , Anestésicos Locais/administração & dosagem , Lidocaína/administração & dosagem , Administração Bucal , Adulto , Análise de Variância , Anestesia Local , Estudos Cross-Over , Teste da Polpa Dentária , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Masculino , MaxilaRESUMO
This study sought to determine the antimicrobial susceptibility of Staphylcoccus aureus and viridans group streptococci strains collected from the forearm skin and saliva of 30 patients at high risk of endocarditis. Agar susceptibility tests of antibiotics routinely utilized in dentistry were used to verify antimicrobial resistance of bacterial strains. Of the Staphylcoccus aureus strains, 50% were resistant to ampicillin, 53.3% to amoxicillin, 60.0% to penicillin G, 13.3% to amoxicillin/clavulanate, 20.0% to azithromycin, 27.6% to clarithromycin, 23.3% to erythromycin, 3.3% to cefazolin, and 6.7% to clindamycin. Regarding streptococci, 16.7% of the strains were resistant to ampicillin, 16.7% to amoxicillin, 23.3% to azithromycin, 23.3% to clarithromycin, 30.0% to erythromycin, 13.3% to cefazolin, 26.7% to clindamycin, 16.7% to penicillin G, and 3.3% to amoxicillin/clavulanate. Pathogens associated with bacterial endocarditis exhibited elevated resistance rates against the antibiotics used for prophylaxis in dentistry.