Efficacy Study of Articaine Versus Lidocaine as Supplemental Infiltration in Inflamed Molars

NCT ID: NCT01496846

Last Updated: 2017-10-31

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

201 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-09-30

Study Completion Date

2016-02-29

Brief Summary

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The purpose of this trial is to study the ability of a frequently used dental anesthetic (articaine) to achieve complete numbness of a diseased tooth with the most commonly used injection technique in the lower jaw (inferior alveolar nerve block: IANB). If this technique fails, a commonly used supplemental (SUP) technique with one of two possible dental anesthetics (lidocaine or articaine) will be given to evaluate the success/failure of complete numbness between the two anesthetics.

Standardized administration of anesthesia is provided by controlled delivery using Midwest Comfort Control Syringe.

The investigators hypothesize that supplemental infiltration anesthesia with articaine will give the same success rate as lidocaine in achieving complete pulpal anesthesia in mandibular molars with irreversible pulpits.

This study consisted of two periods of patient enrollment, treatment and data collection: Part I: 101 subjects; Part II: 100 subjects.

Detailed Description

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The goal of the study is to achieve complete pulpal anesthesia in irreversible pulpitis mandibular molars, either by IANB administration of 4% articaine with 1:100,000 epinephrine (NDA 022466), or in case the IANB appeared to be clinically unsuccessful by supplemental infiltration of either articaine or lidocaine.

The proposed randomized controlled trial (RCT) aims to answer the following questions:

1. What is the success rate of an IANB with articaine using a conventional IANB technique and standardized speed of administration?
2. Is there a difference in complete pulpal anesthetic efficacy using supplemental infiltration with either articaine or lidocaine after an unsuccessful articaine IANB?
3. Is there a difference in first or second molars in achieving complete pulpal anesthesia using supplemental infiltration with either articaine or lidocaine?

This study will combine the data from HUM00049692- Articaine Efficacy in Inflamed Molars to create a larger sample size, giving a total sample size of approximately 200 patients.

Conditions

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Irreversible Pulpitis

Keywords

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Articaine Lidocaine Anesthesia, Local Endodontics Molar Dental Pulp Diseases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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IANB Articaine

IANB Articaine: Inferior alveolar nerve block (IANB) anesthesia with articaine local anesthetic.

Group Type ACTIVE_COMPARATOR

IANB Articaine

Intervention Type DRUG

IANB anesthesia given with 1.7cc of 4% articaine, 1:100,000 epinephrine.

SUP Articaine

SUP Articaine: Supplemental buccal anesthesia (SUP) with articaine local anesthetic after unsuccessful IANB.

Group Type ACTIVE_COMPARATOR

IANB Articaine

Intervention Type DRUG

IANB anesthesia given with 1.7cc of 4% articaine, 1:100,000 epinephrine.

SUP Articaine

Intervention Type DRUG

After unsuccessful IANB with articaine, proceed to give 1.7cc of 4% articaine with 1:100,000 epinephrine in buccal mucosa as a supplemental infiltration injection (SUP).

SUP Lidocaine

SUP Lidocaine: Supplemental buccal anesthesia (SUP) with lidocaine local anesthetic after unsuccessful IANB.

Group Type ACTIVE_COMPARATOR

IANB Articaine

Intervention Type DRUG

IANB anesthesia given with 1.7cc of 4% articaine, 1:100,000 epinephrine.

SUP Lidocaine

Intervention Type DRUG

After unsuccessful IANB with articaine, proceed to give 1.7cc of 2% lidocaine with 1:100,000 epinephrine in buccal mucosa as a supplemental infiltration injection (SUP).

Interventions

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IANB Articaine

IANB anesthesia given with 1.7cc of 4% articaine, 1:100,000 epinephrine.

Intervention Type DRUG

SUP Articaine

After unsuccessful IANB with articaine, proceed to give 1.7cc of 4% articaine with 1:100,000 epinephrine in buccal mucosa as a supplemental infiltration injection (SUP).

Intervention Type DRUG

SUP Lidocaine

After unsuccessful IANB with articaine, proceed to give 1.7cc of 2% lidocaine with 1:100,000 epinephrine in buccal mucosa as a supplemental infiltration injection (SUP).

Intervention Type DRUG

Other Intervention Names

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Articadent (Dentsply Pharmaceutical) Articadent (Dentsply Pharmaceutical) Generic lidocaine (Henry Schein Inc)

Eligibility Criteria

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Inclusion Criteria

* adult patients
* irreversible pulpitis in mandibular molar

Exclusion Criteria

* below 18 years
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dentsply International

INDUSTRY

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Mathilde Peters, DMD, PhD

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mathilde C Peters, DMD, PhD

Role: STUDY_CHAIR

University of Michigan

Tatiana Botero, DDS, MS

Role: STUDY_DIRECTOR

University of Michigan

Locations

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University of Michigan, School of Dentistry Clinics

Ann Arbor, Michigan, United States

Site Status

Countries

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United States

References

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Brandt RG, Anderson PF, McDonald NJ, Sohn W, Peters MC. The pulpal anesthetic efficacy of articaine versus lidocaine in dentistry: a meta-analysis. J Am Dent Assoc. 2011 May;142(5):493-504. doi: 10.14219/jada.archive.2011.0219.

Reference Type BACKGROUND
PMID: 21531931 (View on PubMed)

Rogers BS, McDonald NJ, Gardner R, Botero T, Shlafer M, Peters MC. Anesthetic Efficacy of Articaine vs Lidocaine as Supplemental Infiltration after Unsuccessful IANB of Irreversible Pulpitis Mandibular Molars. AAE Annual Meeting. Honolulu, Hawaii, April 2013.

Reference Type RESULT

Rogers BS, Botero TM, McDonald NJ, Gardner RJ, Peters MC. Efficacy of articaine versus lidocaine as a supplemental buccal infiltration in mandibular molars with irreversible pulpitis: a prospective, randomized, double-blind study. J Endod. 2014 Jun;40(6):753-8. doi: 10.1016/j.joen.2013.12.022. Epub 2014 Feb 8.

Reference Type RESULT
PMID: 24862701 (View on PubMed)

Shapiro MR, McDonald NJ, Gardner RJ, Peters MC, Botero TM. Efficacy of Articaine versus Lidocaine in Supplemental Infiltration for Mandibular First versus Second Molars with Irreversible Pulpitis: A Prospective, Randomized, Double-blind Clinical Trial. J Endod. 2018 Apr;44(4):523-528. doi: 10.1016/j.joen.2017.10.003. Epub 2018 Feb 1.

Reference Type RESULT
PMID: 29397214 (View on PubMed)

Other Identifiers

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HUM00049692

Identifier Type: OTHER

Identifier Source: secondary_id

HUM00088384

Identifier Type: OTHER

Identifier Source: secondary_id

PG#N014189

Identifier Type: -

Identifier Source: org_study_id