• Saudi Med J · Jan 2019

    Randomized Controlled Trial

    Is prilocaine safe and potent enough for use in the oral surgery of medically compromised patients.

    • Giath Gazal.
    • Department of Oral and Maxillofacial, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia. E-mail. gazal73@yahoo.co.uk.
    • Saudi Med J. 2019 Jan 1; 40 (1): 9710097-100.

    ObjectivesTo investigate the potency and speed of action of 2% lidocaine and 3% prilocaine for upper teeth extractions.MethodsThis prospective clinical study was conducted from November 2016 to May 2017. Ninety-six patients, aged between 16 to 70 years old were recruited in this study. Two regimens were randomly administered over one visit. Patients, treatment group I, received 2% lidocaine with 1:00.000 adrenaline. Patients treatment group II received prilocaine 3% and felypressin 0.03 I.U. per ml. The efficacy of pulp anesthesia was determined by electronic pulp testing. At any point of trial (10 minutes), the anesthetized tooth becomes unresponsive for maximal pulp stimulation (64 reading), the extraction was carried out.  Results: There were no significant differences in the mean onset time of pulpal anesthesia and extraction between the prilocaine and lidocaine buccal infiltration groups (p=0.28). However, clinically, the patients in prilocaine group recorded faster onset time of anesthesia and teeth extraction than those in lidocaine group. Conclusion: Prilocaine has a better clinical performance in terms of providing rapid dental anesthesia and earlier teeth extraction than lidocaine but the differences were not significant. Prilocaine with felypressin could be a good choice for patients who have contraindication to the use of lidocaine with adrenaline.

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