Articaine in dentistry: an overview of the evidence and meta-analysis of the latest randomised controlled trials on articaine safety and efficacy compared to lidocaine for routine dental treatment

Martin, Enrico; Nimmo, Alan J.; Lee, Andrew; Jennings, Ernest A.

doi:10.1038/s41405-021-00082-5

Cited by 33 publications

(44 citation statements)

References 94 publications

(146 reference statements)

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“…However, systematic reviews aim to answer a novel question by combining and assessing all the available evidence, and we are very pleased to have published some highquality systematic reviews in 2021. These are evidently of interest to our readership as the paper by Martin et al 34 reviewing articaine in dentistry was the top accessed paper in BDJ Open in 2021. The paper by Johnson et al 36 on contamination by periodontal procedures was also highly viewed.…”

Section: Systematic Reviewsmentioning

confidence: 94%

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BDJ Open 2021 - our most successful year to date

Lewney¹

2022

Br Dent J

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This paper aims to provide an update on the previous version published towards the end of last year, titled ' BDJ Open (2019-2020) and the advantages of open access publishing'. In this paper, we will highlight articles published throughout 2021, in order to focus on which areas authors felt were important to publish open access and also which areas have been expanded upon in the journal. Furthermore, this paper will examine how open access publishing in BDJ Open has enabled the continuous process of hypothesis testing to be shared more widely, as well as how publishing protocols and early results open access gives strength to that by allowing earlier opportunity for comment by other researchers, both through the peer review process and through further correspondence to authors directly and to the journal editors who publish their work.

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Section: Systematic Reviewsmentioning

confidence: 94%

“…There were four systematic reviews published in 2021, 33,34,35,36 with just two published in the whole of 2019-2020. BDJ Open is a research journal and so does not currently publish narrative reviews.…”

Section: Systematic Reviewsmentioning

confidence: 99%

BDJ Open 2021 - our most successful year to date

Lewney¹

2022

Br Dent J

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“…Systematic reviews and meta-analysis are considered the highest, most robust analysis of clinical efficacy across multiple trials [ 7 , 8 ]. Multiple systematic reviews have been conducted on articaine efficacy and safety from 2010 to the present, none of them, nor any of the randomised controlled trials analysed by the reviews reported incidence of permanent nerve paraesthesia following articaine use [ 9 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…The latest articaine systematic review with meta-analyses conducted by Martin et al in 2021 stated that articaine is a safe and efficacious LA for all routine dental treatment [ 12 ]. None of the participants in the 14 randomised controlled trials reported any major LA-related adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Articaine: dental practitioner use, basis of perception and evidence-based dentistry—a cross-sectional study

2022

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Background Limited data exist on dental practitioner use and perceptions of articaine. This study is a cross-sectional survey of dental practitioners from January, 2021 to ascertain the extent of their use of the dental local anaesthetic, articaine, the basis of their perceptions about articaine and whether current practices are in line with recent evidence regarding articaine safety and efficacy. Method An anonymous survey was designed using the SAP Qualtrics Core XM software platform and a survey link was disseminated from December 2020 to January 2021 via social media. The survey was designed as a five minute, anonymous, online questionnaire including a plain language information sheet, request for participant consent and 14 questions. Data were entered onto a Microsoft™ Excel spreadsheet and analysed qualitatively, isolating the answers into recurrent themes. Results Sixty percent of the surveyed dental practitioner used articaine as their preferred dental anaesthetic. Twenty-three percent of the dental practitioner surveyed used articaine for all of their dental procedures including inferior alveolar nerve blocks, while 40% of respondents used articaine for all their dental procedures except inferior alveolar nerve blocks. The predominant basis of dental practitioner uses and perception of articaine were their countries dental guidelines. Conclusion Despite the latest findings that articaine is as safe and more efficacious as lidocaine for all routine dental treatment, 40% of survey respondents avoided articaine use for inferior alveolar blocks. Our study recognises a discrepancy between reported clinical practice and current research evidence. Further research and clarifications are needed to achieve ubiquitous practice of evidence-based dentistry.

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“…Most of the commonly used dental anesthetics include 2% lidocaine and 4% articaine [ 3 , 21 , 22 , 23 , 24 ]. Although considerable evidence supports the safety and efficacy, mixed results also prevail, necessitating multicentric studies globally [ 24 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

A Prospective Clinical Study Evaluating the Efficacy of Intra-Ligamentary Anesthetic Solutions in Mandibular Molars Diagnosed as Symptomatic Irreversible Pulpitis with Symptomatic Apical Periodontitis

et al. 2022

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Accomplishing painless endodontic treatment, especially in the mandibular molar region, is challenging. Hence, the aim of the study was to compare the efficacy of 2% lidocaine and 4% articaine when used as supplemental intra-ligamentary (IL) anesthesia in mandibular molars having symptomatic irreversible pulpitis with symptomatic apical periodontitis after failed Inferior Alveolar Nerve Block (IANB) injection. In this prospective study, one-hundred and forty-seven adult patients diagnosed with irreversible pulpitis in a mandibular tooth were included who received IANB with 1.8 mL of 2% lidocaine with 1:100,000 epinephrine. Patients who experienced pain were recorded using the Heft–Parker visual analog scale (HP-VAS score ≥ 55 mm) and received supplement intra-ligament injection with either4% articaine or 2% lidocaine with 1:100,000 epinephrine. Supplementary intra-ligament injections resulted in 82.6% and 91.3% of profound anesthesia in the first molar region for 2% lidocaine and 4% articaine, respectively. Similarly, an additional IL injection of articaine success percent (78.9%) in the second molar region was higher than lidocaine (63.1%). The overall success ratio revealed no significant difference in achieving profound anesthesia of either solution. In this study population, there was no difference in the success ratio of anesthesia between 2% lidocaine and 4% articaine when used as supplemental IL injection.

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Articaine in dentistry: an overview of the evidence and meta-analysis of the latest randomised controlled trials on articaine safety and efficacy compared to lidocaine for routine dental treatment

Cited by 33 publications

References 94 publications

BDJ Open 2021 - our most successful year to date

BDJ Open 2021 - our most successful year to date

Articaine: dental practitioner use, basis of perception and evidence-based dentistry—a cross-sectional study

A Prospective Clinical Study Evaluating the Efficacy of Intra-Ligamentary Anesthetic Solutions in Mandibular Molars Diagnosed as Symptomatic Irreversible Pulpitis with Symptomatic Apical Periodontitis

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