Final answer:
The absolute highest local anesthetic MRD for lidocaine with epinephrine is 500 mg per appointment, which keeps within the safe dosage limits to prevent lidocaine toxicity.
Step-by-step explanation:
The maximum recommended dose (MRD) of lidocaine with epinephrine for a dental local anesthetic is 7 mg/kg of body weight, with a usual maximum absolute dose limit of 500 mg per appointment. This dosage maximizes the benefits of the anesthetic while minimizing potential risks such as lidocaine toxicity. Therefore, the correct answer to the question is 500 mg per appointment. It is worth noting that this dosage might be lower for individuals with certain medical conditions or those who are particularly sensitive to local anesthetics.