Comparative evaluation of 2% mepivacaine and 2% lidocaine for inferior alveolar nerve block: a double-blind randomized clinical trial
Bibliographic record
Abstract
OBJECTIVE: Lidocaine is the standard dental local anesthetic, while mepivacaine is gaining use despite higher cost and limited comparative data. This study compared the anesthetic efficacy (onset, duration, success rate) of 2% lidocaine with 1:100,000 epinephrine versus 2% mepivacaine with 1:100,000 epinephrine for inferior alveolar nerve block (IANB) in healthy young adults. A secondary aim was to assess whether lidocaine could serve as a cost-effective alternative without reduced clinical performance, particularly when administered by undergraduate dental students. METHODS: A double-blind, randomized clinical trial was conducted involving 62 healthy dental students aged 19-21 years. Participants were randomly assigned to receive either 2% lidocaine or 2% mepivacaine with 1:100,000 epinephrine via conventional IANB technique. The onset time was assessed by pin-prick and cold testing, while the duration of anesthesia was determined by participant self-report. Anesthetic success was defined as achieving effective anesthesia within 10 min post-injection. Adverse events were recorded throughout the study. Group comparisons were analyzed using independent t-tests and chi-square tests, with statistical significance set at P < 0.05. RESULTS: The mean onset time was 5.17 ± 1.96 min for lidocaine and 5.52 ± 1.57 min for mepivacaine (P = 0.435). The mean duration of anesthesia was 214.25 ± 47.52 min for lidocaine and 234.32 ± 39.02 min for mepivacaine (P = 0.073). The success rate within 10 min was 78.6% for lidocaine and 91.2% for mepivacaine, though the difference was not statistically significant. Gender-based subgroup analysis showed no significant differences in anesthetic response. Both anesthetics were well tolerated, with only one minor adverse event reported in the mepivacaine group. CONCLUSION: For inferior alveolar nerve blocks in healthy young adults, lidocaine and mepivacaine performed similarly in terms of onset, duration, and success rate when administered by undergraduate dental students. This suggests both agents provide predictable anesthesia. Given its lower cost and comparable performance, lidocaine may represent a cost-conscious option for routine dental anesthesia. More extensive research with diverse patient groups and operator experience levels is needed to confirm these findings and broaden their applicability. CLINICAL TRIAL REGISTRATION: Registration number is "TCTR20250106002", and date of registration is 06/01/2025, https://www.thaiclinicaltrials.org/show/TCTR20250106002 .
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.006 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".