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Hyaluronidase following buccal infiltrations of articaine with epinephrine for anesthesia of mandibular first molars: A split-mouth, double-blind, placebo-controlled randomized clinical trial

BACKGROUND: Adjunctive hyaluronidase has been widely used for ophthalmic anesthesia; however, in Dentistry, very few studies are available so far. Thus, the present study aimed to evaluate anesthetic outcomes of adjunctive hyaluronidase administration following buccal infiltration of articaine with...

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Autores principales: Gomes, Thiago-Pallin, Palma, Luiz-Felipe, Tornelli, Maurício-José, Tornelli, Helena-Regina, Fukuoka, Cíntia-Yuki, Borsatti, Maria-Aparecida
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medicina Oral S.L. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701347/
https://www.ncbi.nlm.nih.gov/pubmed/36458030
http://dx.doi.org/10.4317/jced.59809
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author Gomes, Thiago-Pallin
Palma, Luiz-Felipe
Tornelli, Maurício-José
Tornelli, Helena-Regina
Fukuoka, Cíntia-Yuki
Borsatti, Maria-Aparecida
author_facet Gomes, Thiago-Pallin
Palma, Luiz-Felipe
Tornelli, Maurício-José
Tornelli, Helena-Regina
Fukuoka, Cíntia-Yuki
Borsatti, Maria-Aparecida
author_sort Gomes, Thiago-Pallin
collection PubMed
description BACKGROUND: Adjunctive hyaluronidase has been widely used for ophthalmic anesthesia; however, in Dentistry, very few studies are available so far. Thus, the present study aimed to evaluate anesthetic outcomes of adjunctive hyaluronidase administration following buccal infiltration of articaine with epinephrine for anesthesia of mandibular first molars. MATERIAL AND METHODS: Twenty-eight patients received a buccal supraperiosteal infiltration of 4% articaine with 1:100,000 epinephrine for anesthesia of the mandibular first molars, in a split-mouth approach. Afterward, randomly and using the same technique, they received either 1.0 mL of hyaluronidase (150 UTR/mL) or a placebo solution. Considering patients’ pain perceptions provoked by electric and mechanical stimulations, as well as using a pain scale, success rate, action onset time, duration of both pulpal and soft tissue anesthesia, and pain immediately after both punctures and on the 2nd day were assessed. RESULTS: The pulpal anesthetic success rate was 85.7% for hyaluronidase and placebo groups. Soft tissue anesthesia showed a shorter action onset time and a longer duration when hyaluronidase was used; however, there was no difference between the groups regarding action onset time and duration of pulpal anesthesia. Pain at the puncture sites did not differ between the groups, regardless of the time point evaluated. CONCLUSIONS: Adjunctive hyaluronidase following buccal infiltration of articaine with epinephrine for mandibular first molars seems not to provide any advantage in anesthetic outcomes in which the nerve fibers are intraosseous (i.e., pulpal anesthesia). On the other hand, soft tissue anesthesia may be improved substantially by using this pharmacological strategy. Key words:Hyaluronidase, local anesthesia, dentistry.
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spelling pubmed-97013472022-11-30 Hyaluronidase following buccal infiltrations of articaine with epinephrine for anesthesia of mandibular first molars: A split-mouth, double-blind, placebo-controlled randomized clinical trial Gomes, Thiago-Pallin Palma, Luiz-Felipe Tornelli, Maurício-José Tornelli, Helena-Regina Fukuoka, Cíntia-Yuki Borsatti, Maria-Aparecida J Clin Exp Dent Research BACKGROUND: Adjunctive hyaluronidase has been widely used for ophthalmic anesthesia; however, in Dentistry, very few studies are available so far. Thus, the present study aimed to evaluate anesthetic outcomes of adjunctive hyaluronidase administration following buccal infiltration of articaine with epinephrine for anesthesia of mandibular first molars. MATERIAL AND METHODS: Twenty-eight patients received a buccal supraperiosteal infiltration of 4% articaine with 1:100,000 epinephrine for anesthesia of the mandibular first molars, in a split-mouth approach. Afterward, randomly and using the same technique, they received either 1.0 mL of hyaluronidase (150 UTR/mL) or a placebo solution. Considering patients’ pain perceptions provoked by electric and mechanical stimulations, as well as using a pain scale, success rate, action onset time, duration of both pulpal and soft tissue anesthesia, and pain immediately after both punctures and on the 2nd day were assessed. RESULTS: The pulpal anesthetic success rate was 85.7% for hyaluronidase and placebo groups. Soft tissue anesthesia showed a shorter action onset time and a longer duration when hyaluronidase was used; however, there was no difference between the groups regarding action onset time and duration of pulpal anesthesia. Pain at the puncture sites did not differ between the groups, regardless of the time point evaluated. CONCLUSIONS: Adjunctive hyaluronidase following buccal infiltration of articaine with epinephrine for mandibular first molars seems not to provide any advantage in anesthetic outcomes in which the nerve fibers are intraosseous (i.e., pulpal anesthesia). On the other hand, soft tissue anesthesia may be improved substantially by using this pharmacological strategy. Key words:Hyaluronidase, local anesthesia, dentistry. Medicina Oral S.L. 2022-11-01 /pmc/articles/PMC9701347/ /pubmed/36458030 http://dx.doi.org/10.4317/jced.59809 Text en Copyright: © 2022 Medicina Oral S.L. https://creativecommons.org/licenses/by/2.5/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Gomes, Thiago-Pallin
Palma, Luiz-Felipe
Tornelli, Maurício-José
Tornelli, Helena-Regina
Fukuoka, Cíntia-Yuki
Borsatti, Maria-Aparecida
Hyaluronidase following buccal infiltrations of articaine with epinephrine for anesthesia of mandibular first molars: A split-mouth, double-blind, placebo-controlled randomized clinical trial
title Hyaluronidase following buccal infiltrations of articaine with epinephrine for anesthesia of mandibular first molars: A split-mouth, double-blind, placebo-controlled randomized clinical trial
title_full Hyaluronidase following buccal infiltrations of articaine with epinephrine for anesthesia of mandibular first molars: A split-mouth, double-blind, placebo-controlled randomized clinical trial
title_fullStr Hyaluronidase following buccal infiltrations of articaine with epinephrine for anesthesia of mandibular first molars: A split-mouth, double-blind, placebo-controlled randomized clinical trial
title_full_unstemmed Hyaluronidase following buccal infiltrations of articaine with epinephrine for anesthesia of mandibular first molars: A split-mouth, double-blind, placebo-controlled randomized clinical trial
title_short Hyaluronidase following buccal infiltrations of articaine with epinephrine for anesthesia of mandibular first molars: A split-mouth, double-blind, placebo-controlled randomized clinical trial
title_sort hyaluronidase following buccal infiltrations of articaine with epinephrine for anesthesia of mandibular first molars: a split-mouth, double-blind, placebo-controlled randomized clinical trial
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701347/
https://www.ncbi.nlm.nih.gov/pubmed/36458030
http://dx.doi.org/10.4317/jced.59809
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