Mechanisms Underlying in Articaine-Related Neurotoxicity

Local anaesthetics are considered very safe when used correctly. The risk of paresthesia after local anaesthesia is often encountered in dental clinics. Several factors can influence the likelihood of paresthesia after local anaesthesia in the field of dentistry. Of particular note is the neurotoxicity of local anaesthetics, a factor that must be given due consideration. It is noteworthy that the incidence of paresthesia after the use of articaine is higher than one might predict based on its market share. In addition, the prevalence of complaints related to its neurotoxic effects is largely attributable to clinical experience, assumptions, and case reports. Several mechanisms have been postulated as causative agents of local anaesthetic neurotoxicity, which can result in cell death. The intrinsic caspase pathway, the PI3K/AKT pathway, the MAPK pathway, calcium overload, oxidative stress, mitochondrial structural changes, lack of neurotrophic factors, and microRNAs, among other factors, have been identified as contributors to the condition. This chapter proposes a review of the mechanisms that have been observed to date by which neurotoxicity has been associated with articaine.