Intraosseous Anaesthesia in Children With 4 % Articaine and Epinephrine 1:400,000 Using Computer-Assisted Systems

Eur Arch Paediatr Dent. 2015 Dec;16(6):477-81. doi: 10.1007/s40368-015-0197-5. Epub 2015 Aug 8.


Aim: To assess retrospectively the efficacy of computer-assisted intraosseous anaesthesia (CAIO) in children using an anaesthetic solution with a lower concentration of epinephrine (1:400,000).

Methods: In a retrospective study, CAIO was evaluated in healthy children and adolescents for restorative and endodontic treatments, uncomplicated tooth extractions or scalings using articaine 4 % plus epinephrine 1:400,000. Anaesthesia was performed in children who showed enough compliance (score of 0-3 according to modified behaviour Venham scale). Efficacy, amount of anaesthetic solution as well as need of a complementary injection was assessed.

Results: A total of 421 consecutive sessions were performed on 278 patients aged 7.1 ± 2.9 years with 518 teeth involved in the anaesthetic process and analysed process. When teeth to be anaesthetised were considered, the overall success rate was 97.2 %. In most of the cases, only 0.9 mL was needed to achieve anaesthesia. Permanent teeth needed significantly more anaesthetics than primary teeth. Sensitivity of the teeth anaesthetized reappeared in 5.7 % of cases after 30-60 min of treatment.

Conclusions: These results suggest that CAIO with 4 % articaine and epinephrine diluted 1:400,000 can be an alternative to usual infiltration techniques or IO with epinephrine at a higher concentration for most of treatments in primary and permanent teeth. Further studies are needed to evaluate its efficacy in permanent teeth in case of endodontic treatment or extraction.

Keywords: Children; Computer-assisted dental anaesthesia; Epinephrine; Intraosseous anaesthesia.

MeSH terms

  • Adolescent
  • Alveolar Process
  • Anesthesia, Dental / instrumentation
  • Anesthesia, Dental / methods*
  • Anesthesia, Local / instrumentation
  • Anesthesia, Local / methods
  • Anesthetics, Local / administration & dosage*
  • Carticaine / administration & dosage*
  • Child
  • Child, Preschool
  • Dental Pulp Capping / methods
  • Dental Restoration, Permanent / methods
  • Epinephrine / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Injections / instrumentation
  • Injections / methods
  • Male
  • Needles
  • Pulpotomy / methods
  • Retrospective Studies
  • Therapy, Computer-Assisted*
  • Tooth Extraction / methods
  • Tooth, Deciduous / drug effects
  • Treatment Outcome
  • Vasoconstrictor Agents / administration & dosage*


  • Anesthetics, Local
  • Vasoconstrictor Agents
  • Carticaine
  • Epinephrine