Comparison of onset and duration of action of soft tissue and pulpal anesthesia with three volumes of 4% articaine with 1:100,000 epinephrine in maxillary infiltration anesthesia.

Purpose: This randomized double-blind investigation was conducted to compare the onset and duration of action of soft tissue and pulpal anesthesia with three volumes of 4% articaine with 1:100,000 epinephrine in maxillary infiltration anesthesia. The injection discomfort associated with three volumes of infiltration anesthesia was also assessed.

Materials and methods: A total of 10 subjects received 0.6 mL (group 1), 0.9 mL (group 2), and 1.2 mL (group 3) of the anesthetic buccal to the upper canine. Test teeth were assessed with electrical stimulation to determine onset and duration of pulpal anesthesia. Soft tissue anesthesia was assessed by pin-prick test, and injection discomfort was assessed using a visual analogue scale. The statistical analysis of the data recorded was carried out with one-way ANOVA and post-hoc tests.

Results: The 1.2-mL dose induced faster onset of pulpal anesthesia, a higher success rate, and a longer duration of soft tissue/pulpal anesthesia than was achieved with 0.6 mL (P < 0.005). No differences in injection discomfort were observed between treatment groups. Group 3 where 1.2 mL of local anesthetic was injected showed faster onset and longer duration of action of articaine. Group 3 also had longer soft tissue anesthesia as compared to groups 1 and 2.

Conclusion: Maxillary infiltration anesthesia with articaine and epinephrine has a faster onset, a greater success rate, and a longer duration when a volume of 1.2 mL is used than when volumes less than 1.0 mL are used. Palatal tissues were anesthetized with the highest concentration (1.2 mL) in our study (30% of cases).