What do systematic reviews say?

4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found

4% prilocaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine

4% prilocaine, 1:200,000 epinephrine may leads to higher success of local anaesthesia (pulpal, electric pulp tester; healthy… compared with 4% articaine, 1:100,000 epinephrine (low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  RR 1.74 [1.16, 2.60]
  2 studies · 78 participants
  Low

4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine

4% articaine, 1:200,000 epinephrine showed no clear difference in success of local anaesthesia (pulpal, electric pulp tester; healthy… compared with 4% articaine, 1:100,000 epinephrine (low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  RR 0.97 [0.87, 1.08]
  5 studies · 248 participants
  Low

4% articaine, 1:200,000 epinephrine vs 0.5% bupivacaine, 1:200,000 epinephrine

It is very uncertain whether 4% articaine, 1:200,000 epinephrine changes speed of onset of anaesthesia (soft tissue, simulated) compared with 0.5% bupivacaine, 1:200,000 epinephrine (very low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  MD -0.85 [-1.26, -0.44]
  2 studies · 69 participants
  Very low

4% articaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

It is very uncertain whether 4% articaine, 1:200,000 epinephrine changes speed of onset of anaesthesia (pulpal, electric pulp tester; healthy… compared with 2% lidocaine, 1:100,000 epinephrine (very low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  MD 0.19 [-2.06, 2.45]
  2 studies · 40 participants
  Very low

0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found

0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

0.5% bupivacaine, 1:200,000 epinephrine showed no clear difference in success of local anaesthesia (pulpal, electric pulp tester; healthy… compared with 2% lidocaine, 1:100,000 epinephrine (low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  RR 0.80 [0.62, 1.05]
  3 studies · 90 participants
  Low

4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

It is very uncertain whether 4% articaine, 1:100,000 epinephrine changes speed of onset of anaesthesia (pulpal, electric pulp tester; healthy… compared with 2% lidocaine, 1:100,000 epinephrine (very low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  MD -0.63 [-1.69, 0.42]
  6 studies · 202 participants
  Very low

0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  'Other comparisons with 100% success': IANB - Sampaio 2012 35/35 vs 35/35; Fernandez 2005 39/39 vs 39/39. Both formulations 100% successful; no meta-analysis (no difference).
  2 studies · 74 participants
  GRADE not reported

4% articaine plain vs 4% articaine, 1:200,000 epinephrine

It is very uncertain whether 4% articaine plain changes speed of onset of anaesthesia (pulpal, electric pulp tester; healthy… compared with 4% articaine, 1:200,000 epinephrine (very low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  MD 0.03 [-0.66, 0.71]
  2 studies · 102 participants
  Very low

3% prilocaine, 0.03 IU felypressin vs 2% lidocaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found

4% prilocaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

4% prilocaine, 1:200,000 epinephrine showed no clear difference in success of local anaesthesia (pulpal, electric pulp tester; healthy… compared with 2% lidocaine, 1:100,000 epinephrine (low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  RR 1.14 [0.91, 1.43]
  2 studies · 48 participants
  Low

3% prilocaine, 0.03 IU felypressin vs 2% lidocaine, 1:100,000 epinephrine

3% prilocaine, 0.03 IU felypressin probably leads to lower success of local anaesthesia, absence of pain (clinical testing of… compared with 2% lidocaine, 1:100,000 epinephrine (moderate certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes

  Not reported (estimated < 2 hours)
  RR 0.86 [0.79, 0.95]
  2 studies · 907 participants
  Moderate

4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine

It is very uncertain whether 4% articaine, 1:200,000 epinephrine changes success of local anaesthesia, absence of pain (clinical testing of… compared with 4% articaine, 1:100,000 epinephrine (very low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes

  5 minutes post-injection to end of clinical procedure
  RR 0.85 [0.71, 1.02]
  3 studies · 930 participants
  Very low

2% mepivacaine, 1:20,000 levonordefrin vs 2% lidocaine, 1:100,000 epinephrine

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  No data available for meta-analysis; orphan clinical success data summarized in Table 6 (e.g. clinical anaesthesia success 2% lidocaine 1:100,000 64/110 vs 2% mepivacaine 1:20,000 levonordefrin 99/113). Not…
  Studies not reported
  GRADE not reported

4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

4% articaine, 1:100,000 epinephrine may leads to higher duration of anaesthesia (soft tissue, simulated) compared with 2% lidocaine, 1:100,000 epinephrine (low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  MD 56.88 [44.08, 69.69]
  2 studies · 422 participants
  Low

4% articaine, 1:200,000 epinephrine vs 0.5% bupivacaine, 1:200,000 epinephrine

It is very uncertain whether 4% articaine, 1:200,000 epinephrine changes duration of anaesthesia (soft tissue, simulated) compared with 0.5% bupivacaine, 1:200,000 epinephrine (very low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  MD -172.61 [-239.69, -105.53]
  2 studies · 39 participants
  Very low

4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine

It is very uncertain whether 4% articaine, 1:200,000 epinephrine changes speed of onset of anaesthesia (pulpal, electric pulp tester; healthy… compared with 4% articaine, 1:100,000 epinephrine (very low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  MD 0.15 [-0.42, 0.73]
  5 studies · 162 participants
  Very low

4% prilocaine, 1:200,000 epinephrine vs 4% prilocaine plain

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  No data available for meta-analysis; data summarized in Table 5 (orphan). Not pooled/graded.
  Studies not reported
  GRADE not reported

Sedation (sedative agents administered via any route) vs General anaesthesia

The review found no eligible studies for this question.

• Sedation versus general anaesthesia for provision of dental treatment to patients younger than 18 years 2015 · Cochrane All outcomes
  no estimate extracted
  0 studies
  No studies found