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The Efficacy of a Repeated Buccal Infiltration of Articaine in Prolonging Duration of Pulpal Anesthesia in the Mandibular First Molar
Lindsay Pabst DDS, MS,
 John Nusstein DDS, MS,
 Melissa Drum DDS, MS,
 Al Reader DDS, MS, and
 Mike Beck DDS, MA
Article Category: Research Article
Volume/Issue: Volume 56: Issue 4
Online Publication Date: Jan 01, 2009
DOI: 10.2344/0003-3006-56.4.128
Page Range: 128 – 134

INTRODUCTION Infiltration anesthesia is a common method used to anesthetize maxillary teeth. However, only recently has infiltration with an articaine formulation been used to anesthetize mandibular first molars. 1 – 4 In 2000, articaine was introduced in the United States. 5 Haas and colleagues 6 , 7 compared infiltrations of 4% articaine and 4% prilocaine formulations in the mandibular canines and second molars. They found no statistical differences between the 2 anesthetic formulations. Success rates (achieving a pulp test

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Yuya Sakurai DDS,
 Makiko Shibuya DDS, PhD,
 Ryuichi Okiji DDS,
 Yuri Hase DDS, PhD,
 Takayuki Hojo DDS, PhD,
 Yukifumi Kimura DDS, PhD, and
 Toshiaki Fujisawa DDS, PhD
Article Category: Case Report
Volume/Issue: Volume 70: Issue 3
Online Publication Date: Oct 18, 2023
Page Range: 116 – 119

It is important to consider the potential for localized tissue damage and altered pharmacokinetics whenever a drug intended to be administered intravenously is inadvertently administered extravascularly. Although rocuronium is routinely used during general anesthesia and in intensive care units, the pharmacokinetics of infiltrated rocuronium have not been investigated, and there are few reports on infiltrated rocuronium in the existing literature. 1 – 4 We report a case of suspected rocuronium infiltration during the induction of general

Alexandra Woo DMD, MS,
 John Nusstein DDS, MS,
 Melissa Drum DDS, MS,
 Sara Fowler DMD, MS,
 Al Reader DDS, MS, and
 Ai Ni PhD
Article Category: Research Article
Volume/Issue: Volume 71: Issue 1
Online Publication Date: May 03, 2024
Page Range: 8 – 14

Palatal anesthesia is indicated for certain dental procedures that create noxious stimulation of the palatal soft tissues such as maxillary extractions, periodontal surgery, and placement of a rubber dam clamp. Unfortunately, palatal injections have been reported to be painful 1 – 3 because the palatal tissues are bound tightly to the periosteum. 4 Due to the pain associated with palatal injections 5 and the supposedly superior perfusion quality of articaine, 6 – 9 numerous articles have reported on the buccal infiltration of articaine for maxillary

Steven Katz DDS, MS,
 Melissa Drum DDS, MS,
 Al Reader DDS, MS,
 John Nusstein DDS, MS, and
 Mike Beck DDS, MA
Article Category: Research Article
Volume/Issue: Volume 57: Issue 2
Online Publication Date: Jan 01, 2010
Page Range: 45 – 51

Maxillary infiltration anesthesia is a common method of anesthetizing maxillary teeth. Previous studies 1 – 18 have evaluated the success of maxillary infiltrations using the electric pulp tester. With a volume of ≤1.8 mL and various anesthetic formulations, pulpal anesthetic success (ie, obtaining maximum output with an electric pulp tester) ranged from 62–100%. Four percent prilocaine with 1 : 200,000 epinephrine has been found to be equivalent to 2% lidocaine with 1 : 100,000 epinephrine for inferior alveolar nerve blocks. 19

Alexandra Woo DMD, MS,
 John Nusstein DDS, MS,
 Melissa Drum DDS, MS,
 Sara Fowler DMD, MS,
 Al Reader DDS, MS, and
 Ai Ni PhD
Article Category: Research Article
Volume/Issue: Volume 70: Issue 3
Online Publication Date: Oct 18, 2023
Page Range: 110 – 115

Articaine differs from other amide local anesthetics because of a thiophene ring and an intramolecular hydrogen bond, which may enhance its diffusion through membranes and connective tissue. 1 Several studies have discussed the clinical increase in the success of articaine. Mandibular first molar buccal infiltrations of articaine were more successful than when lidocaine was used. 2 , 3 One study used 4% concentrations of articaine, lidocaine, and prilocaine for mandibular buccal infiltrations and found that 4% articaine performed the best

Ingrid Lawaty DMD,
 Melissa Drum DDS, MS,
 Al Reader DDS, MS, and
 John Nusstein DDS, MS
Article Category: Research Article
Volume/Issue: Volume 57: Issue 4
Online Publication Date: Jan 01, 2010
Page Range: 139 – 144

Maxillary infiltration anesthesia is a common method to anesthetize maxillary teeth. A number of studies 1 – 5 have evaluated mepivacaine with epinephrine or levonordefrin in operative dentistry and for surgical procedures. However, electric pulp testing was not performed to evaluate pulpal anesthesia. Hinkley et al, 6 in an experimental study of pulpal anesthesia, have shown that 2% mepivacaine with 1 : 20,000 levonordefrin is equivalent to 2% lidocaine with 1 : 100,000 epinephrine for an inferior alveolar nerve block. Because anesthesia

Kevin Younkin DDS, MS,
 Al Reader DDS, MS,
 Melissa Drum DDS, MS,
 John Nusstein DDS, MS, and
 Mike Beck DDS, MA
Article Category: Other
Volume/Issue: Volume 61: Issue 2
Online Publication Date: Jan 01, 2014
Page Range: 63 – 68

Previous studies 1 – 19 have evaluated the success (ie, never achieving 1 or 2 consecutive 80 readings with the electric pulp tester) of maxillary infiltrations. When a volume of 1.8 mL or less was used with various anesthetic formulations, pulpal anesthetic success ranged from 62% to 100%. 1 – 19 Therefore, an infiltration injection may not always be 100% successful because of individual variations in response to the drug administered, operator differences, and variations in anatomy as well as tooth position. Previous studies by

; Incidence of mandibular first molar pulpal anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80 readings), at each postinjection time interval, for the repeated infiltration and mock infiltration. Significant differences are marked with asterisks.
Lindsay Pabst,
 John Nusstein,
 Melissa Drum,
 Al Reader, and
 Mike Beck

Kenji Yoshida DDS, PhD,
 Eri Tanaka DDS, PhD,
 Hiroyoshi Kawaai DDS, PhD, and
 Shinya Yamazaki DDS, PhD
Article Category: Research Article
Volume/Issue: Volume 63: Issue 3
Online Publication Date: Jan 01, 2016
Page Range: 131 – 138

To obtain effective infiltration anesthesia effect in the jawbone, high concentrations of local anesthetic are needed. However, to reduce pain experienced by patients during local anesthetic administration, low-pressure injection is recommended for subperiosteal infiltration anesthesia. Currently, there are no studies regarding the effect of injection pressure on infiltration anesthesia, and a standard injection pressure has not been clearly determined. Hence, this study considered the effect of injection pressure of subperiosteal

Nurain Rehman BDS, and
 Samir Riaz Qazi BDS, FFDRCSI, MPHIL
Article Category: Research Article
Volume/Issue: Volume 66: Issue 1
Online Publication Date: Jan 01, 2019
Page Range: 24 – 29

clinical implication of topical anesthesia being no more effective in pain reduction than placebo is not to use topical prior to LA administration. This clinical approach has not been thoroughly studied in randomized controlled trials and this study aims to compare the effects of the use of topical anesthesia against the use of no topical agent prior to buccal infiltration of LA in maxillary anterior teeth. MATERIALS AND METHODS This experimental nonblinded parallel group randomized clinical trial was conducted on patients presenting for