Loading...
Date
Publisher
MDPI
Abstract
Background: Although allergic reactions to amide local anesthetics (LA) are
rare, it is important for medical professionals to be aware of their potential occurrence.
Despite the fact that articaine is one of the most commonly used LA in dentistry, a survey of
documented cases of allergies to articaine is absent from the literature. The objective of this
review was to ascertain how often true allergies to articaine, verified by standard allergological
procedures, have been reported over the last 25 years. Methods: A comprehensive
review of the literature from 1 January 2000 to 31 December 2024 was conducted using the
PubMed-MEDLINE database. The search was limited to articles investigating suspected
allergy to articaine. The search strategy encompassed indexing terms, keywords, and freetext
words, complemented by an extensive manual search. The final determination was
based on the application of skin and/or challenge tests as the gold standard for identifying
articaine as the causative agent. Results: During the investigation period, 10 case reports
and six case series, encompassing 29 patients with a confirmed true allergy to articaine,
were identified. The age of the patients ranged from 8 to 65 years, with a median age of
34 years. Of these patients, 20 were diagnosed with an immediate type I allergy, while
5 patients exhibited a delayed type IV allergy. In four cases the specific type of allergy was
not mentioned. In the majority of cases an intradermal test (IDT) was employed to ascertain
the specific type of allergy. Cross-reactivity with other amide LA was reported in three
cases. Conclusions: True allergies to articaine are exceedingly rare. Investigation strategies
should include a combination of a thorough clinical history and a standardized allergological
procedure entailing skin tests and challenge. Only a comprehensive approach ensures
the accurate identification of affected patients and facilitates the selection of a tolerated LA.
Metadata
License
Except where otherwised noted, this item's license is described as Attribution 4.0 International