• Roberta Moura Sampaio, Talita Girio Carnaval, Camila Bernardeli Lanfredi, Anna Carolina Ratto Tempestini Horliana, Rodney Garcia Rocha, and Isabel Peixoto Tortamano.
• Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
• J Endod. 2012 May 1;38(5):594-7.

IntroductionThe purpose of this study was to compare the anesthetic efficacy of 0.5% bupivacaine with 1:200,000 epinephrine with that of 2% lidocaine with 1:100,000 epinephrine during pulpectomy in patients with irreversible pulpitis in mandibular posterior teeth.MethodsSeventy volunteers, patients with irreversible pulpitis admitted to the Emergency Center of the School of Dentistry at the University of São Paulo, randomly received a conventional inferior alveolar nerve block containing 3.6 mL of either 0.5% bupivacaine with 1:200,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine. During the subsequent pulpectomy, we recorded the patients' subjective assessments of lip anesthesia, the absence/presence of pulpal anesthesia through electric pulp stimulation, and the absence/presence of pain through a verbal analog scale.ResultsAll patients reported lip anesthesia after the application of either inferior alveolar nerve block. By measuring pulpal anesthesia success with the pulp tester, lidocaine had a higher success rate (42.9%) than bupivacaine (20%). For patients reporting none or mild pain during pulpectomy, the success rate of bupivacaine was 80% and lidocaine was 62.9%. There were only statistically significant differences to the success of pulpal anesthesia.ConclusionsNeither of the solutions resulted in an effective pain control during irreversible pulpitis treatments of mandibular molars.Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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