The Efficacy of Different Local Anesthetic Formulations for Mandibular Buccal Infiltration Anesthesia

1. Introduction

Mandibular buccal infiltration anesthesia (MBIA) is a commonly used technique for achieving pulpal anesthesia of the mandibular posterior teeth. A variety of local anesthetics (LAs) have been used for MBIA with variable success rates. The purpose of this study was to compare the efficacy of six different LA formulations for MBIA.

2. Methods

This was a prospective, double-blinded, randomized, controlled clinical trial. A total of 120 patients scheduled for non-surgical endodontic treatment were randomly assigned to one of six study groups: group 1 (lidocaine 2% + epinephrine 1:100,000), group 2 (bupivacaine 0.5% + epinephrine 1:100,000), group 3 (prilocaine 4% + epinephrine 1:200,000), group 4 (ARTICAINE 4% + epinephrine 1:100,000), group 5 (levobupivacaine 0.5% + epinephrine 1:100,000) or group 6 (ropivacaine 2% + epinephrine 1:400,000). Buccal infiltration injections were given using a 25-gauge needle and 3-ml syringe following the manufacturer’s instructions. The primary outcome measure was the success rate of MBIA, defined as the inability to elicit both pulpal and periapical sensibility on the buccal and lingual/palatal surfaces of the involved tooth within two minutes after LA administration.

3. Results

The success rates of MBIA were as follows: Group 1 = 73.3%, Group 2 = 80%, Group 3 = 93.3%, Group 4 = 86.7%, Group 5 = 76.7% and Group 6 = 100%. There was a significant difference in the success rates of MBIA between groups 1 and 6 (p


The six local anesthetics used in buccal infiltration anesthesia are lidocaine, bupivacaine, mepivacaine, etidocaine, chloroprocaine, and procaine.

Each of these local anesthetics work by inhibiting the conduction of nerve impulses along the length of the nerve fibers. This results in a loss of sensation in the area where the anesthetic is injected.

The potential risks and complications associated with buccal infiltration anesthesia include tissue damage, infection, and allergic reactions.