What do systematic reviews say?

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 success of local 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
  RR 1.33 [0.33, 5.36]
  2 studies · 28 participants
  Very low

2% lidocaine, 1:50,000 epinephrine vs 2% lidocaine, 1:80,000 epinephrine

It is very uncertain whether 2% lidocaine, 1:50,000 epinephrine changes success of local anaesthesia (pulpal, electric pulp tester; healthy… compared with 2% lidocaine, 1:80,000 epinephrine (very low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  RR 0.81 [0.65, 1.01]
  2 studies · 60 participants
  Very low

2% lidocaine, 1:80,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

It is very uncertain whether 2% lidocaine, 1:80,000 epinephrine changes success of local 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
  RR 1.27 [1.01, 1.59]
  2 studies · 60 participants
  Very low

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

4% prilocaine plain may leads to lower success of local anaesthesia, absence of pain (clinical testing of… compared with 2% lidocaine, 1:100,000 epinephrine (low certainty).

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

  5-30 minutes
  RR 0.86 [0.75, 0.99]
  2 studies · 228 participants
  Low

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

4% articaine, 1:200,000 epinephrine showed no clear difference in success of local anaesthesia, absence of pain (clinical testing of… compared with 0.5% bupivacaine, 1:200,000 epinephrine (low certainty).

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

  10 minutes post-injection to end of clinical procedure
  OR 0.87 [0.27, 2.83]
  2 studies · 37 participants
  Low

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

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

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% 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% 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

Hypnosis vs No hypnosis (no hypnotic intervention)

• Hypnosis for children undergoing dental treatment 2010 · Cochrane All outcomes
  With regard to oxygen saturation and pulse rate, only pulse rate was significantly lower in the hypnosis group (P = 0.005); oxygen saturation did not differ significantly. (Gokli 1994; cross-over, 29 children.)
  1 study · 29 participants
  GRADE not reported

Hypnosis vs No hypnosis (no hypnotic intervention)

• Hypnosis for children undergoing dental treatment 2010 · Cochrane All outcomes
  Patients who were hypnotised demonstrated fewer undesirable behaviours (crying, hand movement, physical resistance and leg movement) than those who did not undergo hypnosis. Decreased crying with hypnosis was the only…
  1 study · 29 participants
  GRADE not reported

Hypnosis vs Inhalation sedation with nitrous oxide and oxygen

• Hypnosis for children undergoing dental treatment 2010 · Cochrane All outcomes
  Hypnosis can control some of the patient's negative responses to dental treatment, such as movement and behaviour, during administration of local anaesthesia. (Braithwaite 2005; single-blind cross-over, 10 patients…
  1 study · 10 participants
  GRADE not reported

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

It is very uncertain whether 2% mepivacaine, 1:20,000 levonordefrin changes duration of anaesthesia (soft tissue, simulated) compared with 2% lidocaine, 1:100,000 epinephrine (very low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  MD 4.43 [-10.63, 19.48]
  2 studies · 458 participants
  Very low

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

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

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  MD -8.98 [-15.17, -2.79]
  5 studies · 162 participants
  Very low