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Change of lidocaine concentration in jawbone after infiltration anesthesia. At all time points, lidocaine concentration in jawbone in epinephrine addition group (E⁺) was significantly higher than that in epinephrine additive–free group (E⁰). ** P < .01 E⁺ versus E⁰. * P < .05 E⁺ versus E⁰.

Change of lidocaine concentration in jawbone and oral mucosa in epinephrine addition group after infiltration anesthesia. Lidocaine concentration in jawbone was lower than that in oral mucosa at all time points, and no significant difference was observed between the concentration values of both groups.

Change of lidocaine concentration in jawbone and oral mucosa in epinephrine additive–free group after infiltration anesthesia. Lidocaine concentration in jawbone was lower than that in oral mucosa only at the 10-minute time point. Values thereafter were reversed, and no significant difference was observed between the 2 concentration values of both groups.

Change of jawbone lidocaine concentration after infiltration anesthesia. All 4 groups are compared with each other (6 comparisons). However, only comparisons with significant differences are displayed. The highest value was obtained at 10 minutes after infiltration anesthesia for all groups, and concentration decreased thereafter. Groups with a higher injection pressure had a significantly higher lidocaine concentration in the jawbone at all time intervals.

Location of infiltration anesthesia: 0.5 mL of 2% of lidocaine containing 1 : 80,000 epinephrine or 0.5 mL of 2% of epinephrine additive-free lidocaine was infused into the right maxillae for 20 seconds. Injection site was the buccal side of the third molar on both sides (white arrow). Subperiosteal infiltration anesthesia was performed by touching the needle tip to the jawbone surface under the periosteum.

Method of subperiosteal infiltration anesthesia. The needle tip was inserted into the gingivobuccal fold of the molar mesial buccal region of the right mandible. The local anesthetic was injected by attaching the needle tip to the alveolar bone. After a specified time interval, the periosteum was elevated, and approximately 0.12 g of jawbone was removed using bone-cutting forceps. Sample size (height × weight × depth) was 5 mm × 5 mm × 5 mm. The sample was collected within 1 minute to avoid the influence of the bleeding.

Method of general anesthesia.