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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

CASE PRESENTATION The patient was an 85-year-old woman (height 146 cm; weight 55 kg; body mass index 25 kg/m 2 ) scheduled for right partial maxillary resection and right neck dissection under general anesthesia as treatment for squamous cell carcinoma of the palate. Her medical history included Alzheimer's disease, diabetes mellitus type 2, hypertension, dyslipidemia, C5-C6 cervical spinal stenosis, gastroesophageal reflux disease, and binocular cataracts. In addition, she also had a decreased forced expiratory volume in the first 1 second

Achieving excellent local anesthesia is the key to many dental treatments. Pain-free operating is an added benefit to the patient but also helps the operator to treat the patient in a calm, unhurried fashion. 1 The removal of maxillary third molars is one of the most frequently performed procedures by dental surgeons. Indications for removal include common pathological conditions such as caries, buccal eruption with food impaction or cheek biting, and recurrent pericoronitis. 2 According to the literature, for the removal of

to be lower than that of lidocaine. 7 We hypothesized that a factor that contributed to less effective infiltration anesthesia with ropivacaine was its decreased permeability in oral tissue. In this study, to examine the local distribution of ropivacaine and lidocaine after maxillary infiltration anesthesia, we injected radioisotope-labeled local anesthetics into the rat maxilla, and compared their distributions over time. METHODS Approval from the Animal Care Committee of the Nippon Dental University was obtained before the

Textbooks on local dental anesthesia 2 , 6 suggest that volumes ranging from 0.5 to 2.0 mL are needed to achieve pulpal anesthesia after local infiltration. Cowan 7 , 8 investigated the doses of lidocaine with epinephrine required to allow various operative dental treatments to be performed following maxillary infiltration but did not use a double-blind design or a controlled stimulus and did not investigate injection discomfort. The purpose of this study was to evaluate the onset and duration of pulpal anesthesia in target and adjacent teeth, as well as soft

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

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

for pulpal anesthesia. 4 The molecular structure of articaine is perhaps more important than the concentration, 4 although authors of additional studies may want to explore this association further. Articaine has been compared to lidocaine in several studies. 2 – 20 In asymptomatic subjects, no significant difference in success was found between articaine and lidocaine in the maxillary first molar. 5 , 6 In 2 systematic reviews, Liew et al. 7 and Brandt et al. 8 found that articaine formulations achieved higher success when compared with lidocaine

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

Infiltration anesthesia is a common method to anesthetize maxillary teeth. Previous studies 1 – 13 have evaluated the success of maxillary infiltrations using the electric pulp tester. Using a volume of 1.8 mL or less and various anesthetic formulations, pulpal anesthetic success (obtaining maximum output with an electric pulp tester) has ranged from 64% to 100%. However, the exact effect of an infiltration on adjacent teeth has not been adequately studied. The clinician may perform procedures on adjacent teeth that require pulpal