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Questions and Answers
What is the percentage of lingual nerve involvement reported by Hillerup and Jensen in Denmark in 2006?
What is the percentage of lingual nerve involvement reported by Hillerup and Jensen in Denmark in 2006?
In which country did Garisto et al. report lingual nerve involvement in 92.7% of cases?
In which country did Garisto et al. report lingual nerve involvement in 92.7% of cases?
Which type of nerve block has rarely been reported to cause paresthesia in the mandible?
Which type of nerve block has rarely been reported to cause paresthesia in the mandible?
In which medical specialties has articaine been increasingly used, as mentioned in the text?
In which medical specialties has articaine been increasingly used, as mentioned in the text?
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What has no reported cases of paresthesia following its nondental use?
What has no reported cases of paresthesia following its nondental use?
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Is it highly probable for a drug to be specifically neurotoxic only in the oral cavity?
Is it highly probable for a drug to be specifically neurotoxic only in the oral cavity?
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What is the number of suspected adverse reactions reported to the Danish Medicines Agency for articaine?
What is the number of suspected adverse reactions reported to the Danish Medicines Agency for articaine?
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What is the estimated occurrence of paresthesia after Inferior Alveolar Nerve Block (IANB) injections?
What is the estimated occurrence of paresthesia after Inferior Alveolar Nerve Block (IANB) injections?
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Which local anesthetic is reported to have a lower ratio of paresthesia cases to market share?
Which local anesthetic is reported to have a lower ratio of paresthesia cases to market share?
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What is the primary nerve involved in cases of paresthesia in dentistry?
What is the primary nerve involved in cases of paresthesia in dentistry?
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Which local anesthetic is reported to be more neurotoxic than others and should be avoided for IANB?
Which local anesthetic is reported to be more neurotoxic than others and should be avoided for IANB?
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What is the reported involvement of articaine in causing permanent inferior alveolar and lingual nerve damage?
What is the reported involvement of articaine in causing permanent inferior alveolar and lingual nerve damage?
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What is the primary cause of paresthesia involving the distribution of the lingual nerve?
What is the primary cause of paresthesia involving the distribution of the lingual nerve?
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What is the most common area for reported cases of paresthesia in dentistry?
What is the most common area for reported cases of paresthesia in dentistry?
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Which local anesthetic provides a higher rate of anesthetic success compared to lignocaine?
Which local anesthetic provides a higher rate of anesthetic success compared to lignocaine?
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Which local anesthetic has a shorter elimination half-life than other amide local anesthetics?
Which local anesthetic has a shorter elimination half-life than other amide local anesthetics?
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Which local anesthetic is recommended for special patient populations including children, pregnant women, and nursing mothers due to its shorter elimination half-life?
Which local anesthetic is recommended for special patient populations including children, pregnant women, and nursing mothers due to its shorter elimination half-life?
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Which local anesthetic has been associated with a considerably greater risk of paresthesia when administered by IANB?
Which local anesthetic has been associated with a considerably greater risk of paresthesia when administered by IANB?
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Which local anesthetic is not recommended for IANB by the author due to the risk of paresthesia to the lingual and/or inferior alveolar nerves?
Which local anesthetic is not recommended for IANB by the author due to the risk of paresthesia to the lingual and/or inferior alveolar nerves?
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Which local anesthetic formulation is not available in dental cartridges in North America?
Which local anesthetic formulation is not available in dental cartridges in North America?
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Which local anesthetic has a clinically significant rate of success in providing pulpal anesthesia compared with other amide local anesthetics?
Which local anesthetic has a clinically significant rate of success in providing pulpal anesthesia compared with other amide local anesthetics?
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Which local anesthetic is reported to provide higher anaesthetic success and safety compared to lidocaine?
Which local anesthetic is reported to provide higher anaesthetic success and safety compared to lidocaine?
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What did Albalawi et al. report regarding articaine's block of neuronal responsiveness and toxicity compared to lidocaine?
What did Albalawi et al. report regarding articaine's block of neuronal responsiveness and toxicity compared to lidocaine?
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What should be considered before administering procedures or drugs according to the text?
What should be considered before administering procedures or drugs according to the text?
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Which local anesthetic is preferred in special patient populations due to its shorter elimination half-life and greater lipid solubility?
Which local anesthetic is preferred in special patient populations due to its shorter elimination half-life and greater lipid solubility?
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What did Christenson state regarding observations and studies about paresthesia risk with articaine?
What did Christenson state regarding observations and studies about paresthesia risk with articaine?
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What did the in vitro study find regarding the neurotoxicity of 2% lidocaine and 4% prilocaine?
What did the in vitro study find regarding the neurotoxicity of 2% lidocaine and 4% prilocaine?
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Which local anesthetic is reported to have a greater risk of paresthesia when administered with epinephrine?
Which local anesthetic is reported to have a greater risk of paresthesia when administered with epinephrine?
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Study Notes
Local Anesthetics and Paresthesia in Dentistry
- Informed consent, including discussion of the risk of paresthesia, is necessary before dental procedures, especially those involving the lingual nerve.
- Over 95% of reported cases of paresthesia in dentistry occur in the mandible, with the lingual nerve being involved in the majority of cases.
- 4% articaine appears to be more neurotoxic than other local anesthetics, and its administration via IANB should be avoided.
- The lingual nerve is primarily involved in cases of paresthesia, despite the majority of local anesthetic volume being deposited close to the inferior alveolar nerve during IANB.
- Paresthesia is estimated to occur in 1 in 26,762 IANB injections, and there is no known prevention or treatment for permanent nerve damage.
- Lingual nerve damage is commonly seen as more profound, possibly due to mechanical trauma from the metal needle and the anatomy of the lingual nerve.
- Inferior alveolar nerve typically has more fascicles than the lingual nerve, leading to a smaller area of sensory involvement if damaged, compared to the lingual nerve.
- Paresthesia involving the distribution of the lingual nerve is likely caused by mechanical trauma from the metal needle, while causes for paresthesia involving the inferior alveolar nerve may include neurotoxicity of the local anesthetic, mechanical contact of the needle, edema, and hemorrhage.
- All local anesthetics are neurotoxic, but their neurotoxicity varies, as evidenced by the reported cases of paresthesia not aligning with market share.
- Lidocaine had a lower ratio of reported paresthesia cases to market share, while prilocaine and articaine had higher ratios, indicating their greater involvement in paresthesia cases.
- Articaine is reported to cause proportionate permanent inferior alveolar and lingual nerve damage relative to its market share.
- The number of paresthesia cases caused by lidocaine appears to be lower than its market share in the clinic's evaluation.
Articaine and Local Anesthesia in Dentistry
- Prilocaine caused 26% of cases since 2005 with only 8% market share
- Meta-analyses show articaine provides higher anaesthetic success and safety compared to lidocaine
- Articaine is not toxic to nervous structure, unlike lidocaine and prilocaine
- In vitro study found 2% lidocaine had lower neurotoxicity than 4% prilocaine
- Albalawi et al. reported articaine did not produce prolonged block of neuronal responsiveness or increased toxicity compared to lidocaine
- Benefit vs. risk should be considered before administering procedures or drugs
- No scientific evidence shows increased paresthesia risk with articaine
- Christenson stated that observations and studies do not support increased paresthesia with articaine
- Options for inferior alveolar nerve block (IANB) include 4% articaine, 2% lidocaine, or 2% mepivacaine
- 4% prilocaine with epinephrine has a greater risk of paresthesia
- Articaine provides similar anesthesia depth and duration as other local anesthetics
- Articaine is preferred in special patient populations due to its shorter elimination half-life and greater lipid solubility
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Description
Test your knowledge of local anesthetics and paresthesia in dentistry with this informative quiz. Explore important topics such as nerve damage, neurotoxicity of anesthetics, and the risk factors associated with different local anesthetics. Brush up on the latest research findings and clinical considerations for administering dental procedures and drugs.
