Efficacy of Differents Anaesthetics in Mandibular Third Molar Germectomy
NCT ID: NCT04465149
Last Updated: 2020-07-09
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
50 participants
Study Classification
INTERVENTIONAL
Study Start Date
2018-06-30
Study Completion Date
2020-04-20
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
Aim: To compare the clinical efficacy of local anaesthetics with articaine 4% or mepivacaine 2% (both with epinephrine 1:100.000) using different anaesthetic techniques to perform germectomy of lower third molars and to assess patients' feelings and pain during surgery.
Methods: 50 patients (ranged 11-16 years) who required germectomy of mandibular third molars were recruited. Each patient received local anaesthesia on one side with articaine inoculated with plexus technique while on the other side with mepivacaine using inferior alveolar nerve block technique. The patients' evaluation was performed on pre and intraoperative tactile-pressure feelings and intraoperative pain with four levels on the analogic visual scale (VAS).
Methods: 50 patients (ranged 11-16 years) who required germectomy of mandibular third molars were recruited. Each patient received local anaesthesia on one side with articaine inoculated with plexus technique while on the other side with mepivacaine using inferior alveolar nerve block technique. The patients' evaluation was performed on pre and intraoperative tactile-pressure feelings and intraoperative pain with four levels on the analogic visual scale (VAS).
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Articaine 4% Versus Lidocaine 2% for Local Anesthesia of MIH-affected Maxillary Molars
NCT05585112
Molar Incisor Hypomineralisation
COMPLETED
PHASE1/PHASE2
Evaluation of Articaine 4% Versus Mepivacaine 2% for Surgery of Molars Thirds: Clinical Trial.
NCT03384160
Pain
Teeth, Impacted
COMPLETED
NA
Articaine 4% Efficacy and Safety in Extraction and Pulpotomy of Primary Molars of Children Below the Age of Four Years
NCT05101785
Pain
Behavior
UNKNOWN
NA
Efficacy of 4% Articaine Terminal Anesthesia in the Lateral Jaw Region in Children
NCT05423392
Dental Caries
Primary Teeth
Inferior Alveolar Nerve
+1 more
COMPLETED
NA
Lower Third Molar Removal With 2% and 4% Articaine
NCT02457325
Impacted Third Molar Tooth
Adverse Reaction to Other Local Anesthetics
COMPLETED
PHASE4
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
The surgical extraction of a tooth that exhibits at least a third of its root in formation, with a periodontal ligament discernible on panoramic x-ray, is defined as germectomy. Early germectomy is a usefull intervention to avoid problems caused by lower third molar retention and impaction, and it is often required before or after orthodontic treatment. This surgical technique would also allow to avoid complications, such as inferior alveolar and lingual nerve damage.
The control of the patient's pain and anxiety by using local anaesthesia is essential in oral surgery: these aspects become more important in adolescents, above all in the case of third molar germectomy. Local anaesthetic (LA) injection is often the only painfull part of the dental procedure, and the fear associated with this technique is the main reason that leads patients to avoid dental treatment.
During the execution of dental surgical procedures, anaesthesia of the structures innervated by the mandibular nerve is necessary, and many local anaesthetic techniques are described in the literature. Generally, infiltration plexus technique is usually performed for maxillary procedures while IANB is used for molar mandibular sites with 2% local anaesthetics. Failure rates for IANB are high, sometimes reaching 80% for the lower incisors with this technique, and numerous approaches for the implementation of a new technique of IANB have been described. Among them, the articaine 4% already has been successfully used to achieve local anesthesia and facial infiltration anaesthetic technique in the mandible showed efficacy with encouraging result that can be overlapped to the IANB technique. Articaine (4-methyl-3-\[2-(propylamino)-propionamido\]-2-thiophene-carboxylic acid, methyl ester hydrochloride) contains a thiophene ring instead of benzene and an ester group. The thiophene ring allows for higher lipid solubility so a greater portion of an administered dose can enter in neurons. Gazal found that a combination of nerve block anaesthesia, buccal infiltration and intra-ligamentary injection resulted in more profound anaesthesia (P =0.003) and higher success rates compared to IANB alone in mandibular first molar pulp anaesthesia. Other studies reported the use of articaine in implantology interventions in which it was used with subperiosteal technique on the buccal and vestibular sides.
Thus, the literature showed several conflicting results on the mandibular facial plexus infiltration technique used with different anesthetics.
Recent studies of this anaesthetic technique found that 1.8 cc of 4% articaine facial infiltration in the mandible can be effective when the thickness of mandibular facial cortex is \< 2.0-3.0 mm, with 5-10 minutes needed for the adequate anaesthesia.
It was reported that many dental procedures on deciduous molars could be accomplished with infiltration of articaine alone in the pediatric population.
As above mentioned, the difficulty in achieving reliable anaesthesia in the third mandibular molars in adults with facial infiltration of local anaesthetic is related to the thickness of the cortical bone and inability to achieve consistently inferior alveolar nerve.
An ideal local anaesthetic should have the following characteristics:
1. short latency time;
2. strength of the intense effect;
3. duration of prolonged action;
4. lack of harmful local and systemic effects. Currently, mepivacaine is among the most used and studied anaesthetics in dentistry; however, articaine is nowadays increasingly used for its manageability, lack of side effects and high anaesthetic potency. Mepivacaine is an amide-type anaesthetic with fast action from the beginning and 30-120 minutes duration. Its maximum allowed dose is 300 mg with epinephrine or 500 mg alone. The dose for children is 4-6 mg/kg/dose (maximum: 270 mg) without epinephrine.
Articaine, due to its chemical characteristics, is quickly soluble and rapidly released from adipose/lipid tissue. The ester side chain of articaine is hydrolyzed by plasmaesterases rendering the molecule inactive. Evidence suggests that it is the local anaesthetic that best spreads within soft and hard tissues. Then, it has a non-conducive effect on extended operations having a shorter half-life of 25 minutes compared to approximately 90 minutes of other amides (115 minutes for mepivacaine) that require hepatic clearance. Accordingly, it was suggested that articaine does not own any relevant side effects or systemic toxicities.
For this reason, articaine has been used at higher concentrations (4%), associated with epinephrine, compared to other local dental anesthetics. This higher concentration ensures an excellent spread both in hard and soft tissues, also promoted by a pKa very similar to the physiological pH of tissues. Its great liposolubility allows a rapid diffusion in adipose tissue (spread coefficient = 17,0) and involves a lower adherence to the nerve membranes and, above all, lower toxicity for the tissues. Moreover, articaine has a high protein-based bond (94%) which allows a better affinity for the protein-based membrane receptors, and it is a direct sign of its increased anaesthetic potency.
Dental local anaesthetics are often combined with vasoconstrictors, such as epinephrine, to increase the depth and duration of analgesia. Clinical experiments, in which articaine without vasoconstrictor was used, did not show any satisfying results, whereas the use of articaine combined with low concentrations of vasoconstrictors produced better anaesthetic effects than other common local anaesthetics such as bupivacaine and mepivacaine. It is well documented that vasoconstrictors have a safety range if used at low doses, and not directly injected in the blood vessels, even in particular care patients.
The present study aimed to compare the clinical efficacy of articaine 4% (epinephrine 1:100.000) versus mepivacaine 2% (epinephrine 1:100.000) for the surgical germectomy of mandibular third molars with two different conventional anaesthetic techniques in young patients whom jawbone is not completely mineralized yet and more penetrable by the articaine molecule.
The control of the patient's pain and anxiety by using local anaesthesia is essential in oral surgery: these aspects become more important in adolescents, above all in the case of third molar germectomy. Local anaesthetic (LA) injection is often the only painfull part of the dental procedure, and the fear associated with this technique is the main reason that leads patients to avoid dental treatment.
During the execution of dental surgical procedures, anaesthesia of the structures innervated by the mandibular nerve is necessary, and many local anaesthetic techniques are described in the literature. Generally, infiltration plexus technique is usually performed for maxillary procedures while IANB is used for molar mandibular sites with 2% local anaesthetics. Failure rates for IANB are high, sometimes reaching 80% for the lower incisors with this technique, and numerous approaches for the implementation of a new technique of IANB have been described. Among them, the articaine 4% already has been successfully used to achieve local anesthesia and facial infiltration anaesthetic technique in the mandible showed efficacy with encouraging result that can be overlapped to the IANB technique. Articaine (4-methyl-3-\[2-(propylamino)-propionamido\]-2-thiophene-carboxylic acid, methyl ester hydrochloride) contains a thiophene ring instead of benzene and an ester group. The thiophene ring allows for higher lipid solubility so a greater portion of an administered dose can enter in neurons. Gazal found that a combination of nerve block anaesthesia, buccal infiltration and intra-ligamentary injection resulted in more profound anaesthesia (P =0.003) and higher success rates compared to IANB alone in mandibular first molar pulp anaesthesia. Other studies reported the use of articaine in implantology interventions in which it was used with subperiosteal technique on the buccal and vestibular sides.
Thus, the literature showed several conflicting results on the mandibular facial plexus infiltration technique used with different anesthetics.
Recent studies of this anaesthetic technique found that 1.8 cc of 4% articaine facial infiltration in the mandible can be effective when the thickness of mandibular facial cortex is \< 2.0-3.0 mm, with 5-10 minutes needed for the adequate anaesthesia.
It was reported that many dental procedures on deciduous molars could be accomplished with infiltration of articaine alone in the pediatric population.
As above mentioned, the difficulty in achieving reliable anaesthesia in the third mandibular molars in adults with facial infiltration of local anaesthetic is related to the thickness of the cortical bone and inability to achieve consistently inferior alveolar nerve.
An ideal local anaesthetic should have the following characteristics:
1. short latency time;
2. strength of the intense effect;
3. duration of prolonged action;
4. lack of harmful local and systemic effects. Currently, mepivacaine is among the most used and studied anaesthetics in dentistry; however, articaine is nowadays increasingly used for its manageability, lack of side effects and high anaesthetic potency. Mepivacaine is an amide-type anaesthetic with fast action from the beginning and 30-120 minutes duration. Its maximum allowed dose is 300 mg with epinephrine or 500 mg alone. The dose for children is 4-6 mg/kg/dose (maximum: 270 mg) without epinephrine.
Articaine, due to its chemical characteristics, is quickly soluble and rapidly released from adipose/lipid tissue. The ester side chain of articaine is hydrolyzed by plasmaesterases rendering the molecule inactive. Evidence suggests that it is the local anaesthetic that best spreads within soft and hard tissues. Then, it has a non-conducive effect on extended operations having a shorter half-life of 25 minutes compared to approximately 90 minutes of other amides (115 minutes for mepivacaine) that require hepatic clearance. Accordingly, it was suggested that articaine does not own any relevant side effects or systemic toxicities.
For this reason, articaine has been used at higher concentrations (4%), associated with epinephrine, compared to other local dental anesthetics. This higher concentration ensures an excellent spread both in hard and soft tissues, also promoted by a pKa very similar to the physiological pH of tissues. Its great liposolubility allows a rapid diffusion in adipose tissue (spread coefficient = 17,0) and involves a lower adherence to the nerve membranes and, above all, lower toxicity for the tissues. Moreover, articaine has a high protein-based bond (94%) which allows a better affinity for the protein-based membrane receptors, and it is a direct sign of its increased anaesthetic potency.
Dental local anaesthetics are often combined with vasoconstrictors, such as epinephrine, to increase the depth and duration of analgesia. Clinical experiments, in which articaine without vasoconstrictor was used, did not show any satisfying results, whereas the use of articaine combined with low concentrations of vasoconstrictors produced better anaesthetic effects than other common local anaesthetics such as bupivacaine and mepivacaine. It is well documented that vasoconstrictors have a safety range if used at low doses, and not directly injected in the blood vessels, even in particular care patients.
The present study aimed to compare the clinical efficacy of articaine 4% (epinephrine 1:100.000) versus mepivacaine 2% (epinephrine 1:100.000) for the surgical germectomy of mandibular third molars with two different conventional anaesthetic techniques in young patients whom jawbone is not completely mineralized yet and more penetrable by the articaine molecule.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Local Anesthetic Efficacy
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
Allocation Method
NA
Intervention Model
SINGLE_GROUP
The subjects were children undergoing orthodontic treatment in whom early extraction was indicated to facilitate their treatment in some specific conditions (i.e. posterior crowding, altered second molar eruption, non-extraction approach). For each subject, the first germectomy was scheduled 15 days apart. The same senior operator, assisted by the same practitioner, completed all the surgical procedures. All interventions made with mepivacaine were performed with the same anaesthetic technique routinely used in Oral surgery (IANB). The technique was complemented with anaesthesia of the buccal nerve, as routine for this technique, administering another 1.8 ml of the same anaesthetic used in each intervention. On the other hand, the surgical procedures in articaine cases were made practising a plexus technique, performing a deep buccal injection distally to the second mandibular molar.
Primary Study Purpose
SUPPORTIVE_CARE
Blinding Strategy
NONE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
Patients
Patients who required germectomy of mandibular third molars. Each patient received local anaesthesia on one side with articaine inoculated with plexus technique while on the other side with mepivacaine using inferior alveolar nerve block technique.
Group Type
EXPERIMENTAL
Third Molar Germectomy
Intervention Type
PROCEDURE
Surgical extraction of Third Molars that exhibits at least a third of its root in formation, with a periodontal ligament discernible on panoramic x-ray (defined as germectomy).
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Third Molar Germectomy
Surgical extraction of Third Molars that exhibits at least a third of its root in formation, with a periodontal ligament discernible on panoramic x-ray (defined as germectomy).
Intervention Type
PROCEDURE
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* Patients requiring bilateral germectomy of mandibular third molars before orthodontic treatment
Exclusion Criteria
* Patients presenting systemic and oral diseases
Minimum Eligible Age
11 Years
Maximum Eligible Age
16 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
University of Campania Luigi Vanvitelli
OTHER
Sponsor Role
lead
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Alfredo De Rosa
Associated Professor
Responsibility Role
PRINCIPAL_INVESTIGATOR
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Marco Menditti, Doctor
Role: PRINCIPAL_INVESTIGATOR
University of Campania Luigi Vanvitelli
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
University of Campania Luigi Vanvitelli
Napoli, , Italy
Site Status
Countries
Review the countries where the study has at least one active or historical site.
Italy
References
Explore related publications, articles, or registry entries linked to this study.
Perillo L, Vitale M, d'Apuzzo F, Isola G, Nucera R, Matarese G. Interdisciplinary approach for a patient with unilateral cleft lip and palate. Am J Orthod Dentofacial Orthop. 2018 Jun;153(6):883-894. doi: 10.1016/j.ajodo.2016.12.035.
Reference Type
RESULT
Raucci G, Pacheco-Pereira C, Elyasi M, d'Apuzzo F, Flores-Mir C, Perillo L. Short- and long-term evaluation of mandibular dental arch dimensional changes in patients treated with a lip bumper during mixed dentition followed by fixed appliances. Angle Orthod. 2016 Sep;86(5):753-60. doi: 10.2319/073015-519.1. Epub 2016 Jan 15.
Reference Type
RESULT
Chiapasco M, Crescentini M, Romanoni G. [The extraction of the lower third molars: germectomy or late avulsion?]. Minerva Stomatol. 1994 May;43(5):191-8. Italian.
Reference Type
RESULT
Rayati F, Noruziha A, Jabbarian R. Efficacy of buccal infiltration anaesthesia with articaine for extraction of mandibular molars: a clinical trial. Br J Oral Maxillofac Surg. 2018 Sep;56(7):607-610. doi: 10.1016/j.bjoms.2018.06.012. Epub 2018 Jul 3.
Reference Type
RESULT
Almpani K, Kolokitha OE. Role of third molars in orthodontics. World J Clin Cases. 2015 Feb 16;3(2):132-40. doi: 10.12998/wjcc.v3.i2.132.
Reference Type
RESULT
Bjornland T, Haanaes HR, Lind PO, Zachrisson B. Removal of third molar germs. Study of complications. Int J Oral Maxillofac Surg. 1987 Aug;16(4):385-90. doi: 10.1016/s0901-5027(87)80072-3.
Reference Type
RESULT
Eccleston C. Role of psychology in pain management. Br J Anaesth. 2001 Jul;87(1):144-52. doi: 10.1093/bja/87.1.144.
Reference Type
RESULT
Gunter JB. Benefit and risks of local anesthetics in infants and children. Paediatr Drugs. 2002;4(10):649-72. doi: 10.2165/00128072-200204100-00003.
Reference Type
RESULT
Milgrom P, Coldwell SE, Getz T, Weinstein P, Ramsay DS. Four dimensions of fear of dental injections. J Am Dent Assoc. 1997 Jun;128(6):756-66. doi: 10.14219/jada.archive.1997.0301.
Reference Type
RESULT
Kaufman E, Epstein JB, Naveh E, Gorsky M, Gross A, Cohen G. A survey of pain, pressure, and discomfort induced by commonly used oral local anesthesia injections. Anesth Prog. 2005 Winter;52(4):122-7. doi: 10.2344/0003-3006(2005)52[122:ASP]2.0.CO;2.
Reference Type
RESULT
Khoury J, Townsend G. Neural blockade anaesthesia of the mandibular nerve and its terminal branches: rationale for different anaesthetic techniques including their advantages and disadvantages. Anesthesiol Res Pract. 2011;2011:307423. doi: 10.1155/2011/307423. Epub 2011 May 25.
Reference Type
RESULT
Flanagan DF. The effectiveness of articaine in mandibular facial infiltrations. Local Reg Anesth. 2015 Dec 18;9:1-6. doi: 10.2147/LRA.S94647. eCollection 2016.
Reference Type
RESULT
Saxena P, Gupta SK, Newaskar V, Chandra A. Advances in dental local anesthesia techniques and devices: An update. Natl J Maxillofac Surg. 2013 Jan;4(1):19-24. doi: 10.4103/0975-5950.117873.
Reference Type
RESULT
Meechan JG. The use of the mandibular infiltration anesthetic technique in adults. J Am Dent Assoc. 2011 Sep;142 Suppl 3:19S-24S. doi: 10.14219/jada.archive.2011.0343.
Reference Type
RESULT
Malamed SF. Is the mandibular nerve block passe? J Am Dent Assoc. 2011 Sep;142 Suppl 3:3S-7S. doi: 10.14219/jada.archive.2011.0340.
Reference Type
RESULT
Gazal G, Fareed WM, Zafar MS. Role of intraseptal anesthesia for pain-free dental treatment. Saudi J Anaesth. 2016 Jan-Mar;10(1):81-6. doi: 10.4103/1658-354X.169482.
Reference Type
RESULT
Heller AA, Shankland WE 2nd. Alternative to the inferior alveolar nerve block anesthesia when placing mandibular dental implants posterior to the mental foramen. J Oral Implantol. 2001;27(3):127-33. doi: 10.1563/1548-1336(2001)0272.3.CO;2.
Reference Type
RESULT
Leith R, Lynch K, O'Connell AC. Articaine use in children: a review. Eur Arch Paediatr Dent. 2012 Dec;13(6):293-6. doi: 10.1007/BF03320829.
Reference Type
RESULT
Gazal G. Comparison of speed of action and injection discomfort of 4% articaine and 2% mepivacaine for pulpal anesthesia in mandibular teeth: A randomized, double-blind cross-over trial. Eur J Dent. 2015 Apr-Jun;9(2):201-206. doi: 10.4103/1305-7456.156811.
Reference Type
RESULT
Cowan A. Clinical assessment of a new local anesthetic agent-carticaine. Oral Surg Oral Med Oral Pathol. 1977 Feb;43(2):174-80. doi: 10.1016/0030-4220(77)90153-0.
Reference Type
RESULT
Srisurang S, Narit L, Prisana P. Clinical efficacy of lidocaine, mepivacaine, and articaine for local infiltration. J Investig Clin Dent. 2011 Feb;2(1):23-8. doi: 10.1111/j.2041-1626.2010.00035.x. Epub 2010 Nov 8.
Reference Type
RESULT
Vree TB, Gielen MJ. Clinical pharmacology and the use of articaine for local and regional anaesthesia. Best Pract Res Clin Anaesthesiol. 2005 Jun;19(2):293-308. doi: 10.1016/j.bpa.2004.12.006.
Reference Type
RESULT
Jastak JT, Yagiela JA. Vasoconstrictors and local anesthesia: a review and rationale for use. J Am Dent Assoc. 1983 Oct;107(4):623-30. doi: 10.14219/jada.archive.1983.0307. No abstract available.
Reference Type
RESULT
Leuschner J, Leblanc D. Studies on the toxicological profile of the local anaesthetic articaine. Arzneimittelforschung. 1999 Feb;49(2):126-32. doi: 10.1055/s-0031-1300372.
Reference Type
RESULT
Abazarpoor R, Parirokh M, Nakhaee N, Abbott PV. A Comparison of Different Volumes of Articaine for Inferior Alveolar Nerve Block for Molar Teeth with Symptomatic Irreversible Pulpitis. J Endod. 2015 Sep;41(9):1408-11. doi: 10.1016/j.joen.2015.05.015. Epub 2015 Jul 3.
Reference Type
RESULT
Mittal M, Sharma S, Kumar A, Chopra R, Srivastava D. Comparison of Anesthetic Efficacy of Articaine and Lidocaine During Primary Maxillary Molar Extractions in Children. Pediatr Dent. 2015 Nov-Dec;37(7):520-4.
Reference Type
RESULT
Corbett IP, Kanaa MD, Whitworth JM, Meechan JG. Articaine infiltration for anesthesia of mandibular first molars. J Endod. 2008 May;34(5):514-8. doi: 10.1016/j.joen.2008.02.042.
Reference Type
RESULT
Pellicer-Chover H, Cervera-Ballester J, Sanchis-Bielsa JM, Penarrocha-Diago MA, Penarrocha-Diago M, Garcia-Mira B. Comparative split-mouth study of the anesthetic efficacy of 4% articaine versus 0.5% bupivacaine in impacted mandibular third molar extraction. J Clin Exp Dent. 2013 Apr 1;5(2):e66-71. doi: 10.4317/jced.50869. eCollection 2013 Apr 1.
Reference Type
RESULT
Ram D, Peretz B. Administering local anaesthesia to paediatric dental patients -- current status and prospects for the future. Int J Paediatr Dent. 2002 Mar;12(2):80-9. doi: 10.1046/j.1365-263x.2002.00343.x.
Reference Type
RESULT
Becker DE, Reed KL. Local anesthetics: review of pharmacological considerations. Anesth Prog. 2012 Summer;59(2):90-101; quiz 102-3. doi: 10.2344/0003-3006-59.2.90.
Reference Type
RESULT
Vigen EC, Lasse A. Articaine hydrochloride: is it the solution? Dent Update. 2015 Jun;42(5):493. doi: 10.12968/denu.2015.42.5.493. No abstract available.
Reference Type
RESULT
Kammerer PW, Palarie V, Daublander M, Bicer C, Shabazfar N, Brullmann D, Al-Nawas B. Comparison of 4% articaine with epinephrine (1:100,000) and without epinephrine in inferior alveolar block for tooth extraction: double-blind randomized clinical trial of anesthetic efficacy. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Apr;113(4):495-9. doi: 10.1016/j.tripleo.2011.04.037. Epub 2011 Aug 6.
Reference Type
RESULT
Pabst L, Nusstein J, Drum M, Reader A, Beck M. The efficacy of a repeated buccal infiltration of articaine in prolonging duration of pulpal anesthesia in the mandibular first molar. Anesth Prog. 2009 Winter;56(4):128-34. doi: 10.2344/0003-3006-56.4.128.
Reference Type
RESULT
Dudkiewicz A, Schwartz S, Laliberte R. Effectiveness of mandibular infiltration in children using the local anesthetic Ultracaine (articaine hydrochloride). J Can Dent Assoc. 1987 Jan;53(1):29-31. No abstract available.
Reference Type
RESULT
Tofoli GR, Ramacciato JC, de Oliveira PC, Volpato MC, Groppo FC, Ranali J. Comparison of effectiveness of 4% articaine associated with 1: 100,000 or 1: 200,000 epinephrine in inferior alveolar nerve block. Anesth Prog. 2003;50(4):164-8.
Reference Type
RESULT
Sierra Rebolledo A, Delgado Molina E, Berini Aytis L, Gay Escoda C. Comparative study of the anesthetic efficacy of 4% articaine versus 2% lidocaine in inferior alveolar nerve block during surgical extraction of impacted lower third molars. Med Oral Patol Oral Cir Bucal. 2007 Mar 1;12(2):E139-44.
Reference Type
RESULT
Wright GZ, Weinberger SJ, Marti R, Plotzke O. The effectiveness of infiltration anesthesia in the mandibular primary molar region. Pediatr Dent. 1991 Sep-Oct;13(5):278-83.
Reference Type
RESULT
Ramadurai N, Gurunathan D, Samuel AV, Subramanian E, Rodrigues SJL. Effectiveness of 2% Articaine as an anesthetic agent in children: randomized controlled trial. Clin Oral Investig. 2019 Sep;23(9):3543-3550. doi: 10.1007/s00784-018-2775-5. Epub 2018 Dec 14.
Reference Type
RESULT
Provided Documents
Download supplemental materials such as informed consent forms, study protocols, or participant manuals.
Document Type: Study Protocol and Statistical Analysis Plan
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
SecondUNI-1
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.
Anesthetic Efficacy Of 4% ArtpharmaDent Versus 2% Mepecaine-L in Extraction of Lower First Primary Molars
NCT03942991
UNKNOWN
NA
Efficiency of Single Buccal Infiltration Versus Buccal and Intrapapillary Infiltration
NCT04458142
UNKNOWN
NA
Self-Reported Pain in Children Submitted to Single Infiltration of Articaine During Primary Molar Extraction
NCT05443009
COMPLETED
PHASE4
Comparison of Articaine and Prilocaine for Extraction of Maxillary Teeth
NCT04236115
COMPLETED
PHASE4
Articaine and Bupivacaine in Impacted Tooth Surgery
NCT04645888
COMPLETED
NA
Efficacy and Safety of Administration of Different Doses of 4% Articaine.
NCT06644950
COMPLETED
NA
Articaine Infiltration in Anesthetizing Mandibular Second Primary Molars
NCT06201949
COMPLETED
NA
Comparing Articaine and Mepivacaine Without Palatal Injection in Pain Assessment During Maxillary Teeth Extraction
NCT03470532
COMPLETED
PHASE4
Local Anesthesia With Lidocaine or Articaine for Molars Affected by MIH
NCT05200884
COMPLETED
PHASE1/PHASE2
Comparison of The Effectiveness of Intraligamentary and Mandibular Anesthesia on Mandibular Molar Teeth
NCT05115773
COMPLETED
NA
Hyaluronidase Enzymes and Local Anesthesia
NCT06980363
NOT_YET_RECRUITING
PHASE1
Comparison of the Efficacy and Safety of Two Homologous Active Principles for Local Dental Anesthesia
NCT04166890
COMPLETED
PHASE4
Articaine Versus Lidocaine Buccal Infiltration
NCT05223075
UNKNOWN
PHASE2
Assessment of Anesthetic Efficacy and Hemodynamic Stability of Two LA Drugs for Hypertensive Patients
NCT06927726
ENROLLING_BY_INVITATION
NA
Comparison Between Efficiency of Inferior Alveolar Nerve Block and Buccal Infiltration Techniques Using Articaine 4% 1:100000
NCT03130855
UNKNOWN
NA
2%-Mepivacaine With Two Different Vasoconstrictors Solutions in Third Molar Surgery a Comparative Study
NCT02603198
UNKNOWN
NA
Evaluation of Anesthetic Efficacy in Extraction on Mandibular Molars
NCT03106168
UNKNOWN
NA
Evaluation of the Success Rate of Pulpal Anesthesia in Mandibular First Molar Following Infiltration of 4% Articaine Alone and as Supplemental Injection After Inferior Alveolar Nerve Block
NCT01593930
COMPLETED
NA
Is the Direct Inferior Alveolar Nerve Block Required for Third Lower Molar Extraction?
NCT03443726
COMPLETED
NA
Usefulness of Intraosseous Anesthesia for Permanent Tooth Extraction Under GA in Pediatric Dental Treatment
NCT07108439
RECRUITING
NA
Hemodynamic Effects of Different Vasoconstrictors in Mandibular Exodontia
NCT07013071
COMPLETED
PHASE4
Comparative Evaluation of Three Anxiety Control Protocols in Third Molar Extraction
NCT03165500
COMPLETED
EARLY_PHASE1
Comparing Buccal Infiltration and Inferior Alveolar Nerve Block for Extraction of Mandibular Teeth
NCT04294745
COMPLETED
NA