Anestésicos locais utilizados na odontologia: uma revisão de literatura.

Abstract

Local anesthetics are chemical substances capable of reversibly blocking the transmission of nerve impulses where it is applied and are fundamental in the field of dentistry for the control of pain triggered by oral disorders and clinical and surgical treatments. The objective was to review the literature on the main local anesthetics used in dentistry. The present study deals with a narrative review carried out between January and March 2018. The databases for literature search were Scielo, Pubmed, Web of Science, Bireme. The keywords used in the literature search were Local Anesthetics, Mechanisms of Action, Pharmacology, Dentistry, Structure-activity Relationship, Sodium Channels, present in DeCS. Cocaine was the first compound to be used as a local anesthetic and it was from this that the new anesthetics were developed. Local anesthetics have in their molecular structure an aromatic ring, an intermediate chain and an amine group, they act on the neurons, their site of action are the voltage-dependent sodium channels, to which they bind reversibly, abolishing neuronal excitability. The classification of local anesthetics is defined as regards chemical structure and duration of action, the main ones being used in dentistry lidocaine, mepivacaine, articaine, prilocaine, bupivacaine hydrochloride. According to the literature reviewed, it is necessary for the dental surgeon to know about the individual pharmacological characteristics of the local anesthetics and the patient's systemic ones for a correct choice, since their use is variable for each user, and inappropriate manipulation of these drugs can lead to serious risks to the patient's health.