Comparative study of two local anesthetics in the surgical extractionof mandibular third molars: Bupivacaine and articaine

ABSTRACT

Objective: The third molar extraction is one of the most common surgical procedures in oral surgery and is usuallyaccompanied by postoperative discomfort. It has been suggested that the longer duration of action of bupivacaineassociated with the residual analgesia and the gradual onset of pain, could decrease the need for analgesics duringthe postoperative period. This study aims to compare the efficacy and safety of bupivacaine and articaine as localanesthetics for the extraction of mandibular third molars and to check whether bupivacaine produced residualanalgesia.Study design: We compared bupivacaine 0.5% and articaine 4% with an epinephrine concentration of 1200 000in a crossover design model of extraction of bilaterally symmetrical mandibular third molars.Results: Regarding efficacy, patients experienced less postoperative pain at 6 and 12 hours and shorter durationof soft tissue anesthesia with articaine. With respect to safety, no differences were found between the anestheticscompared, showing a similar local and systemic toxicity. With regard to the preference of patients, it was higherfor articaine, the main reasons being the greater postoperative pain and swelling with bupivacaine.Conclusion: It can be concluded that articaine seems to be a more appropriate anesthetic for the extraction of mandibularthird molars due to the shorter duration of the anesthetic effect in the soft tissues, lower pain reported bypatients during the immediate postoperative period and the personal preference of patients for this drug (AU)

RESUMEN

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