Onset and Duration Period of Pulpal Anesthesia of Articaine and Lidocaine in Inferior Alveolar Nerve Block

Abstract

The purpose of this prospective, randomized, double blind study was to compare the onset and duration periods of pulpal anesthesia using 2% lidocaine with 1:100,000 epinephrine, 4% articaine with 1:100,000 epinephrine and 4% articaine with 1:200,000 epinephrine in inferior alveolar nerve block (IANB). Thirty subjects received 1.8 mL of each of the three local anesthetic solutions in IANB. Onset and duration periods of pulpal anesthesia were determined using electric pulp stimulation. The mean time of onset of pulpal anesthesia was 8.7, 7.4 and 7.7 min and the mean duration of pulpal anesthesia was 61.8, 106.6 and 88.0 min for 2% lidocaine with 1:100,000 epinephrine, 4% articaine with 1:100,000 epinephrine and 4% articaine with 1:200,000 epinephrine, respectively. For onset, there was only a significant difference between 2% lidocaine with 1:100,000 epinephrine and 4% articaine with 1:100,000 epinephrine (p=0.037). For duration, there was significant difference for all the local anesthetic solutions (p≤0.05). In conclusion, 4% articaine with 1:100,000 epinephrine exhibited faster onset and also had longest duration of pulpal anesthesia in IANB.

A Comparison of Different Volumes of Articaine for Inferior Alveolar Nerve Block for Molar Teeth with Symptomatic Irreversible Pulpitis

“…Articaine is an anesthetic solution that was approved by the Food and Drug Administration for use in dentistry in the United States in 2000 (13). Articaine is claimed to provide faster onset and longer duration of pulp anesthesia compared with lidocaine (14). Several investigations have compared the anesthetic efficacy of articaine with other anesthetic agents (15)(16)(17)(18)(19).…”

A comparative evaluation of the efficacy of 4% articaine (1:100000 adrenaline) and 2% lignocaine (1:100000 adrenaline) in surgical extraction of mandibular third molars

“…Thereby, it penetrates the nerve membrane more easily and also due to a lower dissociation constant (pKa-7.8) of articaine which is comparable to lignocaine(pKa-7.9) which results in large number of lipophilic free base molecules that are able to diffuse through the nerve sheath thereby lowering the onset time (6,10,11). These characteristics also result in shorter time of onset of hard and soft tissue anaesthesia with articaine (12,13) The present study coincided with the study of Sierra-Rebolledo A et Al (14) who found the difference between the mean subjective onset between 4% articaine with 1:100000 adrenaline and 2% lignocaine with 1:100000 adrenaline to be 19 seconds with articaine having a shorter onset of anesthesia. Martinez-Rodriguez N et al (15) reported latency period of 1.04 min and 3.75 min respectively for Articaine and Lignocaine with the difference being more than 2 minutes with articaine having a shorter onset time.…”

Articaine in Endodontics: A Review.

“…37 Articaine is an anesthetic solution that was approved by the Food and Drug Administration for use in dentistry in the United States in 2000. 38 Articaine is claimed to provide faster onset and longer duration of pulp anesthesia compared with lidocaine. 39 Several investigations have compared the anesthetic efficacy of articaine with other anesthetic agents.…”

“…39 Several investigations have compared the anesthetic efficacy of articaine with other anesthetic agents. [40][41][42][43][44][45] The results of these studies have shown no significant difference between articaine and lidocaine when used for IANB injections. 40 [46][47] A second molecular difference is the ester linkage incorporated into the articaine molecule, which results in hydrolysis of articaine by plasma esterase"s. Ninety to 95 percent of articaine is metabolized in the blood by plasma esterase"s, with the remainder being broken down in the liver, 46 whereas approximately 90 percent of lidocaine is metabolized by the liver.…”