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For safe treatment of dental patients, a dental local anesthetic is required that exhibits low cardiac activity and low toxicity. Articaine is a widely used dental local anesthetic agent that differs from the other amide agents because of the presence of a thiophene ring and an ester group. It is hydrolyzed by plasma esterase and is biotransformed by hepatic microsomal enzymes, resulting in a short plasma half-life of approximately 20–30 minutes. 1 However, articaine has a plasma protein–binding capacity of approximately 95%, which is

related to the local anesthetic blood level and is directly related to the arterial PaCO 2 level. Stress can lead to sympathetic hyperactivity, resulting in tachycardia and tachypnea, in turn leading to increased PaO 2 and decreased PaCO 2 . This model can be used to study their effects on local anesthetic toxicity. Today, 2 of the most commonly used local anesthetics are lidocaine and articaine. 19 Thus, by using the model of stress-induced changes in these parameters, investigators undertook this study to confirm that changes in PaCO 2 and PaO 2 can

more painful when compared to buccal infiltration, mental nerve block, or periodontal ligament injections. 3 Unpleasant treatment experiences negatively influence the child's behavior toward dental treatment. 4 As dentists, therefore, we should strive to utilize less traumatic alternative local anesthesia techniques to obviate the pain of multiple injections, if adequate local anesthesia can be obtained, by reducing the number of injections or injecting in less painful sites. 1 , 3 Articaine is unique among local anesthetic agents of the amide group

Palatal anesthesia is indicated for certain dental procedures that create noxious stimulation of the palatal soft tissues such as maxillary extractions, periodontal surgery, and placement of a rubber dam clamp. Unfortunately, palatal injections have been reported to be painful 1 – 3 because the palatal tissues are bound tightly to the periosteum. 4 Due to the pain associated with palatal injections 5 and the supposedly superior perfusion quality of articaine, 6 – 9 numerous articles have reported on the buccal infiltration of articaine for maxillary

toxicity is rarely reported; these events are invariably the result of overdoses in young children. 2 , 3 Two percent lidocaine with 1:100,000 epinephrine is the most widely used local anesthetic in the United States, 1 while in Canada and several European countries, articaine with 1:100,000 epinephrine has supplanted lidocaine as the most frequently employed local anesthetic agent. 4 Four percent articaine with 1:100,000 epinephrine provides more profound infiltration anesthesia than does 2% lidocaine with 1:100,000 epinephrine. 5 While it is not as clear if

INTRODUCTION Infiltration anesthesia is a common method used to anesthetize maxillary teeth. However, only recently has infiltration with an articaine formulation been used to anesthetize mandibular first molars. 1 – 4 In 2000, articaine was introduced in the United States. 5 Haas and colleagues 6 , 7 compared infiltrations of 4% articaine and 4% prilocaine formulations in the mandibular canines and second molars. They found no statistical differences between the 2 anesthetic formulations. Success rates (achieving a pulp test

Maxillary third molar extraction is generally straightforward, due to the plasticity of the maxillary bone and to the low resistance to extraction movements. Nevertheless, the anesthetic technique needed for such extraction may be extremely uncomfortable because it requires palatal mucosal anesthesia. 1 , 2 Studies have suggested that articaine has good diffusion through the hard and soft tissues, eliminating the need for the palatal injection in maxillary third molar extractions. 3 – 6 However, the anesthetic effect may be

The most common local anesthetics used in dentistry are the tertiary amines, with lidocaine and articaine probably the most frequently used specific agents. 1 – 3 The commonly used 2% lidocaine with 1:100,000 epinephrine (henceforth “lidocaine”) onset is reported between 2 and 3 minutes, with an anesthetic duration of approximately 60 to 85 minutes for pulpal anesthesia, and 120 to 180 minutes for soft tissues. 2 , 4 It has low toxicity in comparison to other local anesthetics, and its safety is well recognized in the dental

but not in others. 3 Postoperative pain was reported in 71% of the injected sites. 2 Articaine was approved for use in the United States in April 2000 9 and is available as a 4% solution with 1:100,000 or 1:200,000 epinephrine. Articaine is classified as an amide but contains a thiophene ring instead of a benzene ring like other amide local anesthetics. 9 A second molecular difference between articaine and other amide local anesthetics is the extra ester linkage incorporated into the articaine molecule, which results in hydrolysis of articaine by plasma

Articaine differs from other amide local anesthetics because of a thiophene ring and an intramolecular hydrogen bond, which may enhance its diffusion through membranes and connective tissue. 1 Several studies have discussed the clinical increase in the success of articaine. Mandibular first molar buccal infiltrations of articaine were more successful than when lidocaine was used. 2 , 3 One study used 4% concentrations of articaine, lidocaine, and prilocaine for mandibular buccal infiltrations and found that 4% articaine performed the best