J Dent Anesth Pain Med.  2015 Jun;15(2):69-76.

The efficacy of an elevated concentration of lidocaine HCl in impacted lower third molar surgery

• Ping B
• Kiattavorncharoen S
• Saengsirinavin C
• Im P
• Durward C
• Wongsirichat N

Abstract

BACKGROUND
There have been few studies on the effect of an elevated concentration of lidocaine hydrochloride in the surgical removal of an impacted lower third molar. This study aimed to examine the efficacy of 4% lidocaine along with 1:100,000 epinephrine compared to 2% lidocaine along with 1:100,000 epinephrine as inferior alveolar nerve block for the removal of an impacted lower third molar.
METHODS
This single-blind study involved 31 healthy patients (mean age: 23 y; range: 19-33 y) with symmetrically impacted lower third molars as observed on panoramic radiographs. Volunteers required 2 surgical interventions by the same surgeon with a 3-week washout period. The volunteers were assigned either 4% lidocaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine as local anesthetic during each operation.
RESULTS
We recorded the time of administration, need for additional anesthetic administration, total volume of anesthetic used. We found that the patient's preference for either of the 2 types of local anesthetic were significantly different (P < 0.05). However, the extent of pulpal anesthesia, surgical duration, and duration of soft tissue anesthesia were not significantly different.
CONCLUSIONS
Our study suggested that inferior alveolar nerve block using 4% lidocaine HCl with 1:100,000 epinephrine as a local anesthetic was clinically more effective than that using 2% lidocaine HCl with 1:100,000 epinephrine; the surgical duration was not affected, and no clinically adverse effects were encountered.

Keyword

Efficacy; Electric pulp testing (EPT); Inferior alveolar nerve block (IANB); Lidocaine hydrochloride concentration; Local anesthetic; Third molar; Tooth impaction

MeSH Terms

Anesthesia
Epinephrine
Humans
Lidocaine*
Mandibular Nerve
Molar, Third*
Single-Blind Method
Volunteers
Epinephrine
Lidocaine

Figure

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  Fig. 1 Distribution of the volunteers according to the occurrence of pulpal sensitivity at 10 min after inferior alveolar nerve block administration, based on electric pulp testing.

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