A Prospective, Randomized, Double-blind Comparison of the Anesthetic Efficacy of Two Percent Lidocaine with 1:100,000 Epinephrine and Three Percent Mepivacaine in the Maxillary High Tuberosity Second Division Nerve Block

IntroductionThe purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of 2% lidocaine with 1:100,000 epinephrine and 3% mepivacaine in the maxillary high tuberosity second division nerve block.MethodsFifty subjects randomly received maxillary high tuberosity second division nerve blocks by using 3.6 mL of 2% lidocaine with 1:100,000 epinephrine and 3.6 mL of 3% mepivacaine at 2 separate appointments spaced at least 1 week apart. The anterior, premolar, and molar teeth were pulp tested in 4-minute cycles for a total of 60 minutes. Success was defined as no subject response to 2 consecutive 80 readings with the electric pulp tester.Results and ConclusionsThe high tuberosity approach to the maxillary second division nerve block with both anesthetic formulations resulted in a high success rate (92%–98%) for the first and second molars. Approximately 76%–78% of the second premolars were anesthetized with both anesthetic formulations. Both anesthetic formulations were ineffective for the anterior teeth and first premolars. The use of 3% mepivacaine provided a significantly shorter duration of pulpal anesthesia than 2% lidocaine with 1:100,000 epinephrine in the molars and premolars.