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Periodontal ligament injection: alternative solutions.

R J Gray¹, A M Lomax, J P Rood

¹Turner Dental School, Manchester.

Anesthesia Progress

|November 1, 1990

Summary

Epinephrine-free local anesthetics like lidocaine, mepivacaine, and prilocaine showed limited success for periodontal ligament anesthesia. Lidocaine without epinephrine was particularly ineffective, suggesting current alternatives are not ideal.

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Area of Science:

Dentistry
Anesthesiology
Periodontology

Background:

Periodontal ligament (PDL) anesthesia is crucial for dental procedures.
Epinephrine is commonly used in local anesthetics to prolong their effect but carries risks.
There is a need for effective epinephrine-free local anesthetic alternatives for PDL injections.

Purpose of the Study:

To evaluate the efficacy of plain lidocaine, 3% plain mepivacaine, and 3% prilocaine with felypressin as epinephrine-free local anesthetics for PDL anesthesia.
To compare these agents against lidocaine with epinephrine (1:80,000).

Main Methods:

A randomized clinical study involving 207 patients.
Administration of one of four test solutions via PDL injection.
Assessment of anesthetic success using an electric pulp stimulator.

Main Results:

None of the tested epinephrine-free solutions achieved the same efficacy as lidocaine with epinephrine.
Mepivacaine and prilocaine showed similar, though lower, success rates compared to lidocaine with epinephrine.
Lidocaine without epinephrine demonstrated consistently poor anesthetic success.
Overall, a single PDL injection of any tested solution resulted in a low incidence of profound anesthesia.

Conclusions:

Plain lidocaine, mepivacaine, and prilocaine are not as effective as epinephrine-containing lidocaine for PDL anesthesia.
Further research is needed to identify reliable epinephrine-free anesthetic options for PDL injections.
The efficacy of epinephrine-free local anesthetics in PDL anesthesia remains a challenge.

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