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Epinephrine and local anesthesia revisited

      The issue concerning how much and under what circumstances epinephrine vasoconstriction within dental local anesthesia is appropriate has been strenuously debated over the last 50 years. Because relevant human and animal studies are difficult to perform, there are, at present, insufficient data to answer many of our questions. Many of the previous conclusions regarding safety and efficacy were based upon incomplete understanding, bias, and limited scientific and clinical data.
      • Bader J.D.
      • Bonito A.J.
      • Shugars D.A.
      A systemic review of cardiovascular effects of epinephrine on hypertensive dental patients.
      Well designed controlled, randomized, and blinded studies are the gold standard with regard to determining pharmacotherapeutic efficacy and safety.
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