The effectiveness of articaine in mandibular facial infiltrations

Figures & data

Figure 1 Mandibular infiltration is delivered to the facial aspect of the mandible.

Figure 2 Measurements were taken on the CBCT from the tooth apex to the facial aspect of the mandible and the thickness of the cortex at that location.

Abbreviation: CBCT, cone beam computerized tomography.

Table 1 An electrical pulp tester was used to determine if the subject tooth was anesthetized at 2, 5, and 10 minutes after infiltration of articaine

Patient	Tooth number	Apical cortical thickness on CBCT (mm)	Apex to facial cortex on CBCT (mm)	Pulp test at 2 minutes	Pulp test at 5 minutes	Pulp test at 10 minutes	Approximate cortical/trabecular HU values	Procedure
Patient 1	19 M	3.20 M	4.6 M	+	+	+	1,360/190	Restoration
	19 D	3.30 D	4.70 D	+	+	+	1,321/167
Patient 2	22	1.35	5.14	+	+	−	801/167	Adjacent implant
Patient 3	23	1.15	2.24	+	+	−	1,230/345	Adjacent implant
Patient 4	31	1.67	3.65	+	+	−	1,022/442	Extraction
Patient 5	22	1.83	6.23	+	+	−	940/580	Extraction
	25	1.35	3.27	+	+	−	951/568	Extraction
	26	1.11	3.81	+	+	−	294/179	Extraction
	27	2.33	4.96	+	+	−	858/241	Extraction
Patient 6	22	1.72	3.01	+	−	−	960/444	Extraction
Patient 6	27	1.76	2.99	+	−	−	824/647	Extraction
Patient 7	21	2.33	4.44	+	+	−	1,253/256	Adjacent implant
	22	2.62	4.47	+	+	−	1,405/848	Adjacent implant
	27	2.93	4.12	+	+	−	1,508/624	Adjacent implant
	28	1.74	4.48	+	+	−	1,444/477	Adjacent implant
Patient 8	20	1.60	6.29	+	−	−	487/271	Adjacent implant
	21	2.17	5.18	+	−	−	831/203	Adjacent implant
	22	2.60	4.54	+	+	−	520/281	Adjacent implant
Patient 9	22	2.06	5.34	+	−	−	636/361	Restoration
	27	2.66	5.11	+	−	−	1,328/424	Restoration

Notes: Each cortical thickness was measured using the CBCT. Each distance from the tooth apex to the facial aspect of the cortex was measured using the CBCT. Cortical and trabecular HU values were measured for each site. Each tooth was slated for a restoration, an extraction, or an adjacent edentulous implant. All teeth were sensate at zero start time and after 2 minutes. After 5 minutes, 14 teeth were sensate and six were insensate. After 10 minutes, all teeth were insensate except one first molar. + = sensate, − = insensate.

Abbreviations: CBCT, cone beam computerized tomography; HU, Hounsfield units; M, mesial; D, distal.

Table 2 The average cortical thicknesses of each site were calculated

Average cortical thickness (mm) – sensate at 5 minutes	Average cortical thickness (mm) – insensate at 5 minutes	Average cortical thickness (mm) – sensate at 10 minutes (one molar with two roots)	Average cortical thickness (mm) – insensate at 10 minutes
2.12	2.00	3.25	1.94

Note: The thickest cortices did not attain anesthesia.

Table 3 The average apex to facial cortex distance was measured

Average apical distance (mm) – sensate at 5 minutes	Average apical distance (mm) –insensate at 5 minutes	Average apicaldistance (mm) – sensate at 10 minutes
4.33	4.65	4.65

Note: The position of the tooth apex from the facial aspect of the cortex did not appear to influence the attainment of anesthesia.

Table 4 The HU values for each site, cortical/trabecular, were measured using the CBCT

Average HU – sensate at 5 minutes	Average HU – insensate at 5 minutes	Average HU – sensate at 10 minutes	Average HU – insensate at 10 minutes
1,065/383	844/392	1,341/179	961/409

Note: HU measurements using the CBCT are not accurate for bone density due to technical anatomical factors.

Abbreviations: HU, Hounsfield units; CBCT, cone beam computerized tomography.