Comparison of anesthetic efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine for inferior alveolar nerve block in patients with irreversible pulpitis

Abstract

Objectives: This study was done to compare the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine with that of 2% lidocaine with 1:80,000 epinephrine during pulpectomy in patients with irreversible pulpitis for inferior alveolar nerve block in mandibular posterior teeth. Material and Methods: Patients with irreversible pulpitis referred to the Department of Conservative Dentistry and Endodontics, K.D. Dental College, randomly received a conventional inferior alveolar nerve block containing 1.8 mL of either 4% articaine with 1:100,000 epinephrine or 2% lidocaine with 1:80,000 epinephrine. After the patient’s subjective assessment of lip anesthesia, the absence/presence of pulpal anesthesia through electric pulp stimulation was recorded and the absence/presence of pain was recorded through visual analogue scale. Results: The pulpal anesthesia success for articaine (76%) was slightly more than with lidocaine (58%) as measured with pulp tester as well as for the pain reported during the procedure the success rate of articaine (88%) was slightly more than that of lidocaine (82%) although the difference between the two solutions was not statistically significant. Conclusions: Both the local anesthetic solutions had similar effects on patients with irreversible pulpitis when used for inferior alveolar nerve block. Key words:Anesthesia, articaine, lignocaine, pulpitis.

Does Articaine Provide an Advantage over Lidocaine in Patients with Symptomatic Irreversible Pulpitis? A Systematic Review and Meta-analysis

“…In one study the risks were unclear across all categories (43). Conflict of interest was denied in 4 studies (36,39,40,42) and not mentioned in the other 6 studies. One study disclosed receiving financial support from a pharmaceutical company that provided materials and supplies (40), and 4 studies disclosed receiving academic institution financial support (37,(39)(40)(41).…”

“…Seven studies were excluded because they did not meet the inclusion criteria: not a randomized double-blind study (28)(29)(30)(31), did not compare articaine and lidocaine (29,32,33), or did not provide dichotomous data (34). The remaining 10 studies met the inclusion criteria and were included in the meta-analysis (35)(36)(37)(38)(39)(40)(41)(42)(43)(44).…”

“…In addition, it is important to acknowledge that in common with previous reviews (18,19), the underlying heterogeneity of the included studies presents limitations. Such heterogeneity includes geographic location, sample size, number and experience of operators, potential variations in approaches to diagnose symptomatic irreversible pulpitis (cold test, electric pulp test, and patient history), the volume of anesthetic, the concentration of epinephrine, reproducibility of injection route, and evaluation scale used to assess pain and definition of success (VAS, HP-VAS, access cavity, endodontic [43]); 0 = no pain; 1 = mild, bearable pain; 2 = moderate, unbearable pain; 3 = severe, intense, and unbearable pain (Sood et al [42]). § Verbal analog scale: 0 = no pain; 1 = mild, bearable pain; 2 = moderate, unbearable pain; 3 = severe, intense, and unbearable pain (Tortamano et al [44]).…”

Efficacy of articaine vs lignocaine in maxillary and mandibular infiltration and block anesthesia in the dental treatments of adults: A systematic review and meta‐analysis

“…Eight studies were excluded because they did not meet the inclusion criteria: (a) was not a randomized, double‐blind study; (b) did not compare articaine and lignocaine; (c) used a 4% concentration of lignocaine; or (d) did not provide dichotomous data. The remaining 18 studies met the inclusion criteria and were included in the meta‐analysis . The characteristics of the included trials, including their methodological quality, are summarized in Table .The intervention compared was the use of either articaine or lignocaine to anesthetize the teeth (including in healthy volunteers and patients with symptomatic irreversible pulpitis or requiring exodontia).…”

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

“…In contrast, Claffey et al (15) used 2.2 mL articaine for IANBs in their study, and they reported a 24% success rate for mandibular posterior teeth with irreversible pulpitis, which is comparable with the results of the present study when the patients received only 1.8 mL articaine (27.5%). Another investigation that used 1.8 mL articaine reported a 76% success rate, which is the highest success rate of IANBs when only 1 cartridge of articaine was used for posterior teeth with irreversible pulpitis (30).…”