Comparison of two epinephrine concentrations in an articaine solution for local anesthesia in children

Painless dental treatment is of major interest in pediatric dentistry. Local anesthesia contains epinephrine, which prolongs soft tissue anesthesia.This, however, is often a source of iscomfort for children and is responsible for certain side effects (e.g., self-inflicted soft tissue lesions). The aim of this study was to investigate whether an epinephrine-reduced articaine solution could reduce the duration of soft tissue anesthesia and thereby reduce the risk of self-inflicted soft tissue lesions, while still providing an adequate anesthesia. In a non-interventional clinical study, routine dental treatment was performed on children and adolescents. An articaine 4% solution with an epinephrine-reduced solution (Ubistesin™ mite, 1:400,000) and a conventional epinephrine solution (Ubistesin™ forte, 1:100,000) were compared in terms of duration of soft tissue anesthesia. One hundred and fifty-eight patients (mite: 75, forte: 83) were treated (80% with infiltration anesthesia). In both groups, the average volume of the injection was comparable (mite: 1.2 ml, forte: 1.1 ml). One patient from each group showed unwanted side effects. In both groups, the local anesthesia was complete or sufficient (96%) to perform the planned treatment. The average treatment time was 24 minutes in the mite group and 28 minutes in the forte group. The difference in mean duration of soft tissue anesthesia was statistically significant (p = 0.001, mite: 2.1 h, forte: 2.8 h). Thanks to its high efficacy, tolerance, and reduced soft tissue anesthesia, the articaine 4% solution with the reduced epinephrine concentration (1:400,000) was considered a safe and suitable drug for routine treatments in pediatric dentistry.