Data sources The following traditional databases were searched until January 2018; Cochrane Central Register of Controlled Trials (CENTRAL); the Cochrane Library; Issue 1, MEDLINE Ovid, Embase Ovid, CINHAL Plus and the Institute of Scientific Information (ISI) Web of Science. In addition, five more databases (IndMED, KoreaMED, Panteleimon, ANZCTR and Ingenta Connect) and bibliographies. References lists were also searched until January 2018 as well as handsearching of multiple relevant journals and potential sources of unpublished studies.Study selection All included studies were randomised controlled trials comparing different agents, different dosage or different concentration of local anaesthetics in clinical procedures or simulated scenarios using parallel or cross-over design with no language or year of publication restrictions. Data extraction and synthesis Two reviewers independently selected, reviewed and extracted data using a standardised form. Risk of bias was also assessed by two authors. Quality of the evidence was evaluated by the GRADE approach. Treatment effect was presented as odds ratios (OR) and risk ratios (RR) with 95% confidence intervals (CI) for binary data, while mean differences (MD) with 95% CI was used for continuous data. Statistical heterogeneity was calculated by the 'Q' statistic and I2. 'Summary findings' tables were created for eight comparisons. Subgroup analysis was performed based on the tissue anaesthetised.Results From the 123 studies (19,223 participants) on dental anaesthesia using commercially available formulations that met the inclusion criteria, 68 studies with 6615 participants were included for quantitative analysis. The comparison of 4% articaine, 1:100.000 adrenaline with 2% lidocaine, 1:100.000 adrenaline was reported as the main comparison and included the results of four studies with 203 participants with irreversible pulpitis during endodontic access and instrumentation. For the primary outcome of success, as measured by the absence of pain, the calculated RR of 1.60 (95% CI 1.10 to 2.32) favoured articaine with low heterogeneity. No evidence of difference was observed on pain during injection (MD 4.74 mm, 95% CI -1.98 to 11.46 mm) or following injection (MD 6.41 mm CI 95% 1.01 to 11.80 mm) based on three cross-over studies comparing the same formulations used for the evaluation of success.Conclusions The authors concluded there is no sufficient high quality evidence to determine which formulation is more effective. Four percent, 1:100,000 adrenaline was superior to lidocaine 2%, 1:100,000 epinephrine when measuring success on posterior teeth with irreversible pulpitis. Two percent lidocaine, 1:100,000 epinephrine was superior to 3% prilocaine 0.03 IU felypressin during surgical procedures and 4% prilocaine plain during surgical and periodontal treatment.

中文翻译：

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用于牙科麻醉的可注射局部麻醉剂。

数据来源截至2018年1月，搜索了以下传统数据库；Cochrane对照试验中央登记册（CENTRAL）；科克伦图书馆；第1期，MEDLINE Ovid，Embase Ovid，CINHAL Plus和科学信息研究所（ISI）的Web of Science。此外，还有五个数据库（IndMED，KoreaMED，Panteleimon，ANZCTR和Ingenta Connect）和书目。直到2018年1月也要检索参考文献清单，并手动搜索多个相关期刊和未发表研究的潜在来源研究选择所有纳入的研究都是随机对照试验，比较了临床过程或模拟方案中不同药物，不同剂量或不同浓度的局部麻醉药。使用没有语言或出版年份限制的并行或交叉设计。数据提取和综合两名审阅者使用标准化形式独立选择，审阅和提取数据。两位作者也评估了偏见的风险。证据的质量通过GRADE方法进行评估。对于二进制数据，以95％置信区间（CI）的优势比（OR）和风险比（RR）表示治疗效果，而对于连续数据则以95％CI的平均差异（MD）表示。统计异质性由“ Q”统计量和I2计算得出。创建了“摘要调查结果”表以进行八次比较。根据被麻醉的组织进行亚组分析。结果来自123项研究（19,223名参与者）的牙科麻醉研究使用了符合纳入标准的市售制剂，包括6615名参与者的68项研究进行了定量分析。据报道，将4％青蒿素，1：100.000肾上腺素与2％利多卡因，1：100.000肾上腺素进行比较是主要比较，其中包括四项研究的结果，其中有203名在牙髓接触和器械治疗期间患有不可逆性牙髓炎的参与者。对于成功的主要结局，以无疼痛来衡量，计算得出的RR为1.60（95％CI为1.10至2.32），因此青蒿素的异质性较低。根据三项交叉研究比较相同制剂，在注射过程中（MD 4.74 mm，95％CI -1.98至11.46 mm）或注射后（MD 6.41 mm CI 95％1.01至11.80 mm），疼痛均未观察到差异。用于评估成功。结论作者得出结论，没有足够的高质量证据来确定哪种制剂更有效。当测量不可逆性牙髓炎后牙的成功率时，百分之四的1：100,000肾上腺素优于利多卡因2％的1：100,000肾上腺素。在手术过程中，百分之二的利多卡因，1：100,000肾上腺素优于3％的丙胺卡因0.03 IU飞利普汀，而在手术和牙周治疗中则优于4％的丙胺卡因。