What do systematic reviews say?

2% lidocaine, 1:50,000 epinephrine vs 2% lidocaine, 1:100,000 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, 1:100,000 epinephrine (very low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  RR 0.99 [0.88, 1.12]
  7 studies · 210 participants
  Very low

2% lidocaine, 1:50,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  '100% success' (lidocaine 1:100,000 vs 1:50,000): infraorbital block - Berberich 2009 40/40 vs 40/40; mandibular BI - Dagher 1997 30/30, Yonchak 2001 40/40; IANB - Yared 1997 30/30, Wali 2010 30/30. Both 100% successful.
  5 studies · 170 participants
  GRADE not reported

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

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  '100% success': mandibular BI - Dagher 1997 30/30 vs 30/30; IANB - Yared 1997 30/30 vs 30/30. Both 100% successful; no meta-analysis.
  2 studies · 60 participants
  GRADE not reported

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

2% lidocaine, 1:50,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

It is very uncertain whether 2% lidocaine, 1:50,000 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 -0.44 [-1.66, 0.79]
  4 studies · 92 participants
  Very low

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

It is very uncertain whether 2% lidocaine, 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 0.89 [0.63, 1.26]
  3 studies · 70 participants
  Very low

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

3% mepivacaine plain vs 2% lidocaine, 1:100,000 epinephrine

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  '100% success' (lidocaine 1:100,000 vs 3% mepivacaine plain): infraorbital block - Berberich 2009 40/40 vs 40/40; IANB - Cohen 1993 27/27 vs 34/34, McLean 1993 30/30 vs 30/30. Both 100% successful.
  3 studies · 121 participants
  GRADE not reported

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

4% prilocaine plain 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 0.93 [0.75, 1.17]
  2 studies · 60 participants
  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

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

4% articaine, 1:100,000 epinephrine may leads to higher 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

  10 minutes post-injection to end of clinical procedure
  RR 1.6 [1.1, 2.32]
  4 studies · 203 participants
  Low

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
  No data from the included studies were available.
  0 studies
  No studies found

2% mepivacaine, 1:100,000 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 - Allegretti 2016 22/22 vs 22/22; Visconti 2016 21/21 vs 21/21. Both formulations 100% successful; no meta-analysis (no difference).
  2 studies · 43 participants
  GRADE not reported

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

It is very uncertain whether 4% prilocaine plain 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 -33.95 [-48.05, -19.84]
  3 studies · 698 participants
  Very 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 (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 -0.23 [-0.45, -0.01]
  6 studies · 637 participants
  Very low

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

4% prilocaine, 1:200,000 epinephrine showed no clear difference in speed of onset 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 -0.01 [-0.14, 0.11]
  2 studies · 421 participants
  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 duration of anaesthesia (pulpal, electric pulp tester; healthy pulps) compared with 2% lidocaine, 1:100,000 epinephrine (very low certainty).

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  MD 10.33 [-22.08, 42.74]
  2 studies · 40 participants
  Very low