Comparison Of Articaine Plasma Concentration Under Periodontal Ligament,Submucosal,and Intravenous Injection

Objective:Local anesthesia is commonly used in oral treatment to alleviate patient pain.Currently,submucosal anesthesia and periodontal ligament anesthesia are two commonly used methods in clinics.However,when compared,periodontal ligament anesthesia takes effect quickly but its duration is relatively shorter.Therefore,we detected the plasma concentration of articaine after submucosal injection and periodontal ligament injection,and used the plasma concentration data after intravenous injection of articaine as a reference to explore the difference of drug metabolism between submucosal and periodontal ligament injection.Methods:This single-centered,open,self-controlled clinical study was conducted on 10 healthy male and female Chinese participants.The participants were administered 0.3ml of 4%articaine with 1:100,000 epinephrine through periodontal ligament injection,submucosal injection,and intravenous injection,in sequence.A one-week cleaning period was implemented between each injection.Pharmacokinetic characteristics of articaine following periodontal ligament and submucosal injections were evaluated by articaine plasma concentration.The anesthesia effect was assessed by stimulating the injected tooth with ice.Result:Based on the actual operation situation,we divided the periodontal ligament injection group into successful and failed groups for comparison.The AUC0-75min,Cmax,and tmax of successful and failed periodontal ligament injection groups differed significantly.There was insignificant difference in vivo exposure between the successful periodontal ligament injection group and the submucosal injection group(AUC0-75min 55.5±25.8 vs 67.3±20.7;Cmax 192.6±125.2 vs 142.5±51.2);the time to reach peak concentration was significantly later for submucosal injection compared to the successful periodontal ligament injection group(10 min vs.1 min).Conclusion:Comparing the plasma concentration of articaine between the successful periodontal ligament injection group and the submucosal injection group may explain the faster onset of periodontal ligament anesthesia than submucosal anesthesia,which also may providing evidence that periodontal ligament injection anesthesia can be a rapid and effective supplemental anesthesia.With regards to the safety of local anesthesia,both periodontal ligament and submucosal anesthesia are relatively safe but should still be discussed separately.When encountering difficulties in reaching the enough injection depth or experiencing resistance during periodontal ligament injection,effective periodontal ligament injection may not be achieved.