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References

Kakroudi SHA, Mehta A, Millar BJ. Articaine hydrochlorides: Is it the right solution?. Dent Update. 2015; 42:88-93
Hillerup S, Jensen R. Nerve injury caused by mandibular block analgesia. Int J Oral Maxillofac Surg. 2006; 35:437-443
Garisto GA, Gaffen AS, Lawrende HP, Tenenbaum HC, Haas DA. Occurrence of paresthesia after dental local anesthetic administration in the United States. J Am Dent Assoc. 2010; 141:836-844
Werdehausen R, Fazeli S, Braun S, Hermanns H, Essmann F, Hollmann MW, Bauer I, Stevens MF. Apoptosis induction by different local anaesthetics in a neuroblastoma cell line. Br J Anaesth. 2009; 103:711-718
Malet A, Faure M-O, Deletage N, Pereira B, Haas J, Lambert G. The comparative cytotoxic effects of different local anesthetics on a human neuroblastoma cell line. Anesth Analg. 2015; 120:589-596
Wells JP, Beckett H. Articaine hydrochloride: a safe alternative to lignocaine?. Dent Update. 2008; 35:253-256
Lambert LA, Lambert DH, Stricharzt GR. Irreversible conduction block in isolated nerve by high concentrations of local anesthetics. Anesthesiology. 1994; 80:1082-1093
Oertel R, Berndt A, Kirch W. Saturable in vitro metabolism of articaine by serum esterases. Does it contribute to the persistence of the local anaesthetic effect?. Reg Anesth. 1996; 21:576-581

Authors' response

From Volume 42, Issue 5, June 2015 | Page 493

Authors

Brian Millar

Co-workers King's College London Dental Institute

Articles by Brian Millar

Article

The authors thank Professors Vigen and Skoglund for their letter adding further information about articaine following our recent paper (Kakroudi et al Dent Update 2015; 42: 88–93). We agree with the points raised and concur that reducing the volume of articaine administered would be expected to reduce the incidence of parasthesia following an IANB. However, avoidance or a reduction in the use of the IANB would be an even more significant factor in reducing the risk of paraesthesia. The beneficial properties of articaine, as outlined in our paper, allows alternative, and easier, techniques to be considered.

Dose is, indeed, a complex issue as, due to the difference in molecular weight between articaine and lidocaine, there are not twice as many molecules in articaine 4% as in lidocaine 2%; there are actually less than double and it is the number of molecules that is relevant to the efficacy of a dose-dependent drug. The key message for clinicians is that much less articaine is required.