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Fernadez C, Reader C et al. Endodon 2005; 31: 499–503

Bupivacaine provides anaesthesia of about twice the duration of that with lidocaine in standard doses. This study compared inferior alveolar nerve blocks with the two anaesthetics in 39 subjects. Injections were spaced at least 1 wk apart, and given on the same side of the mouth. Test teeth were I2, P1, P2, M1 and M2.

Pulp testing identified onset of anaesthesia with bupivacaine at a mean 6.53 min, and with lidocaine at 4.89 min (P = 0.03). Respective times for duration of numbness were 411 and 192 min, and for return to normal sensation, 493 and 220. For all teeth except M1, lidocaine was more successful. The authors discuss other factors including postoperative pain and analgesic medication, and conclude that lidocaine may be the anaesthetic of choice for endodontic purposes.