Hemodynamic Effects of Different Vasoconstrictors in Mandibular Exodontia

NCT ID: NCT07013071

Last Updated: 2025-06-12

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

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

52 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-10

Study Completion Date

2024-05-20

Brief Summary

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Title of Study:

The Effect of Different Vasoconstrictive Agents on Hemodynamics Among Patients Undergoing Simple Mandibular Exodontia: A Triple-Blind Randomized Controlled Trial

Location:

King Abdulaziz University Dental Hospital (KAUFD), Jeddah, Saudi Arabia What Is This Study About?

This study examines two types of vasoconstrictive agents used alongside local anesthetic during simple lower tooth extractions:

* Epinephrine (1:100,000)
* Epinephrine Bitartrate (1:55,000)

What are vasoconstrictors? Vasoconstrictors help control bleeding and extend the numbing effect during dental procedures. They are usually added to local anesthetics (numbing agent) during dental procedures. This research aims to answer the following questions:

1. Which one of the vasoconstrictive agents has less effect on the heart rate and blood pressure
2. Which one offers better pain control?

Who Can participate?

* Adult patient +18 year/old or above (healthy or with well-controlled conditions like hypertension)
* Patients who require non-surgical lower tooth extractions
* Procedures will be done by supervised fifth and sixth-year dental students

Potential Risks and Discomforts

Like any medical procedure, there are some potential risks, including:

From the anesthesia and vasoconstrictors:

* Allergic reaction
* Prolonged numbness
* Changes in blood pressure and heart rate

From the tooth extraction itself:

* Bleeding
* Pain or discomfort
* Swelling or bruising
* Infection
* Dry socket
* Delayed healing
* Damage to nearby teeth or tissues
* Fracture of the tooth or jawbone
* Numbness or altered sensation (temporary or permanent)
* Sinus complications (in upper tooth extractions)
* The need for additional procedures

Potential Benefits

* Free tooth extraction
* Blood pressure monitoring - with referral to a primary care provider if undiagnosed high blood pressure is detected

Costs There are no additional costs to participate in this research. Treatment and extraction are provided free of charge.

Compensation / Treatment for Injury

If a participant is injured as a result of being in this study:

* Necessary treatment and medical care will be provided by the research team.
* No financial compensation is available from King Abdulaziz University Dental Hospital (KAUFD).

Confidentiality Participants' identity and medical information will be kept confidential. Only authorized researchers and relevant oversight bodies may access Participants' medical/dental records for monitoring or auditing purposes, in accordance with laws and regulations. Any published results will not identify the participants.

Detailed Description

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Conditions

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Hemodynamics Pain ASA I-II Requiring Simple Dental Extraction of a Mandibular Tooth

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This study used a triple-blind, parallel assignment randomized controlled trial design. Participants were randomly assigned to one of two groups: one group received 2% mepivacaine with 1:100,000 epinephrine, and the other received 2% mepivacaine with 1:55,000 epinephrine bitartrate. Both groups underwent simple mandibular tooth extraction, and their hemodynamic responses and pain levels were assessed at standardized intervals. The study maintained blinding across patients, care providers, and outcome assessors to minimize bias.
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Epinephrine Group (1:100,000)

Participants in this group received local anesthesia consisting of 2% mepivacaine hydrochloride with 1:100,000 (0.01 mg/mL) epinephrine prior to simple mandibular tooth extraction. This arm served as the comparator for evaluating hemodynamic changes and pain control.

Group Type ACTIVE_COMPARATOR

2% Mepivacaine with 1:100,000 epinephrine

Intervention Type DRUG

A standard vasoconstrictor-containing local anesthetic used in dental procedures to minimize bleeding and prolong anesthetic effect.

Epinephrine Bitartrate Group (1:55,000)

Participants in this group received local anesthesia consisting of 2% mepivacaine hydrochloride with 1:55,000 (0.018 mg/mL) epinephrine bitartrate prior to simple mandibular tooth extraction. This arm was evaluated for its effects on hemodynamic parameters and pain perception compared to standard epinephrine.

Group Type EXPERIMENTAL

2% Mepivacaine with 1:55,000 Epinephrine Bitartrate

Intervention Type DRUG

An alternative formulation of vasoconstrictor-containing local anesthetic evaluated for its safety and analgesic effectiveness in dental extractions.

Interventions

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2% Mepivacaine with 1:100,000 epinephrine

A standard vasoconstrictor-containing local anesthetic used in dental procedures to minimize bleeding and prolong anesthetic effect.

Intervention Type DRUG

2% Mepivacaine with 1:55,000 Epinephrine Bitartrate

An alternative formulation of vasoconstrictor-containing local anesthetic evaluated for its safety and analgesic effectiveness in dental extractions.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Adults aged 18 years or older.
* ASA I or II classification (i.e., healthy or with mild systemic disease).
* Requiring simple mandibular tooth extraction, as defined by painless removal with minimal tissue trauma and smooth postoperative healing.
* Willing and able to provide informed consent.
* Able to comply with study procedures (able to undergo the simple tooth extraction).

Exclusion Criteria

* Pregnant or lactating individuals.
* ASA III or higher classification (i.e., patients with severe systemic disease).
* Patients with uncontrolled systemic disease.
* History of malignancy.
* Presence of unstable psychiatric illness.
* Current use of antiplatelet or anticoagulant medications.
* Known allergies to local anesthetics.
* Uncooperative patients or those with intellectual disabilities.
* Cases requiring surgical extractions (e.g., needing tooth sectioning, mucoperiosteal flaps, or bone removal).
* Patients requiring maxillary tooth extraction.
* Presence of fascial space infection or acute oral conditions.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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King Abdulaziz University

OTHER

Sponsor Role lead

Responsible Party

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Razan Baabdullah

Assistant professor of oral and maxillofacial surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Razan M Baabdullah, BDS, MS, FRCDC

Role: PRINCIPAL_INVESTIGATOR

King Abdulaziz University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery

Locations

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King Abdulaziz University, Faculty of Dentistry

Jeddah, Mecca Region, Saudi Arabia

Site Status

Countries

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Saudi Arabia

References

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Reference Type RESULT
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Gupte SH, Kalra RD, Dcruz TM, Kamble S, Patnaik RS. Comparative Evaluation of Effectiveness of 2% Lignocaine Hydrochloride with Clonidine Hydrochloride versus 2% Lignocaine Hydrochloride with Adrenaline Bitartrate as Local Anesthetic for Adult Patients Undergoing Surgical Extraction of Impacted Mandibular Third Molars: A Randomized Controlled Clinical Study. Contemp Clin Dent. 2021 Jul-Sep;12(3):308-312. doi: 10.4103/ccd.ccd_665_20. Epub 2021 Sep 21.

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Silvestre FJ, Martinez-Herrera M, Garcia-Lopez B, Silvestre-Rangil J. Influence of anxiety and anesthetic vasoconstrictors upon hemodynamic parameters during dental procedures in controlled hypertensive and non-hypertensive patients. J Clin Exp Dent. 2021 Feb 1;13(2):e156-e164. doi: 10.4317/jced.57232. eCollection 2021 Feb.

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Seminario-Amez M, Gonzalez-Navarro B, Ayuso-Montero R, Jane-Salas E, Lopez-Lopez J. USE OF LOCAL ANESTHETICS WITH A VASOCONSTRICTOR AGENT DURING DENTAL TREATMENT IN HYPERTENSIVE AND CORONARY DISEASE PATIENTS. A SYSTEMATIC REVIEW. J Evid Based Dent Pract. 2021 Jun;21(2):101569. doi: 10.1016/j.jebdp.2021.101569. Epub 2021 Apr 10.

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Reference Type RESULT
PMID: 20835569 (View on PubMed)

Tsuchihashi T, Takata Y, Kurokawa H, Miura K, Maruoka Y, Kajiyama M, Fujishima M. Blood pressure response during dental surgery. Hypertens Res. 1996 Sep;19(3):189-94. doi: 10.1291/hypres.19.189.

Reference Type RESULT
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Silvestre FJ, Salvador-Martinez I, Bautista D, Silvestre-Rangil J. Clinical study of hemodynamic changes during extraction in controlled hypertensive patients. Med Oral Patol Oral Cir Bucal. 2011 May 1;16(3):e354-8. doi: 10.4317/medoral.16.e354.

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Abhijith George, Mandeep Sharma, Prasanna Kumar, Sneha Kulkarni, Vinay Patil y Jacob John Plackal. Hemodynamic changes during exodontia in hypertensive and normotensive patients following injection of local anesthetics with and without epinephrine: a prospective comparative study. Rev Esp Cir Oral Maxilofac. 2022;44(1):9-15.

Reference Type RESULT

Ogunlewe MO, James O, Ajuluchukwu JN, Ladeinde AL, Adeyemo WL, Gbotolorun OM. Evaluation of haemodynamic changes in hypertensive patients during tooth extraction under local anaesthesia. West Indian Med J. 2011 Jan;60(1):91-5.

Reference Type RESULT
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Matsumura K, Miura K, Takata Y, Kurokawa H, Kajiyama M, Abe I, Fujishima M. Changes in blood pressure and heart rate variability during dental surgery. Am J Hypertens. 1998 Nov;11(11 Pt 1):1376-80. doi: 10.1016/s0895-7061(98)00157-5.

Reference Type RESULT
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Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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240-11-23

Identifier Type: -

Identifier Source: org_study_id

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