The effectiveness of articaine and lidocaine single buccal infiltration versus conventional buccal and palatal injection using lidocaine during primary maxillary molar extraction: A randomized control trial

Abstract

Background:Despite the advent of modern injection techniques, palatal injection continues to be a painful experience for children.Aims:To compare the pain experienced during extraction of maxillary primary molars with conventional lignocaine anesthesia versus lignocaine and articaine buccal infiltration in children aged 6–14 years.Materials and Methods:A prospective randomized triple blinded study was conducted with ninety children (n = 90), randomly allocated to receive lignocaine conventional anesthesia (Group I [control group]), and buccal infiltration using articaine (Group II [articaine group]) or lignocaine (Group III [lignocaine group]). A composite score of self-report (faces pain scale-revised), behavioral measure (face legs activity cry consolability scale), and a physiological response (pulse rate) was measured following maxillary primary molar extraction.Statistical Analysis Used:To test the mean difference between two groups, Students’ t-test was used and among the three groups, one-way ANOVA with post hoc test was used.Results:Articaine group had significantly lower pain scores for self-report (P < 000.1) and behavioral measures (P < 000.1) while there was no significant difference (P > 0.05) between articaine and control groups during primary maxillary molar extraction.Conclusion:Maxillary primary molar extraction procedure can be successfully accomplished by bypassing the palatal injection. Articaine buccal infiltration can be considered as an alternative to conventional local anesthesia for the extraction of maxillary primary molars.

Comparing the Efficiency of 2% Lidocaine and 4% Articaine as a Local Anesthetic Agent in Children

“…Several studies have reported with similar results [16][17][18][19][20]. There was a significant difference between the articaine group (Group C) and the lidocaine group (Group B) in terms of pain perception.…”

Anaesthetic efficacy of articaine versus lidocaine in children's dentistry: a systematic review and meta‐analysis

“…The dosage and amounts of the two LA agents used were not uniform across studies. Only two studies compared equivalent concentrations of articaine and lidocaine, whereas the others had variable amounts administered to the child in which the maximum dose was calculated per body weight.…”

“…Four of six studies evaluated the occurrence of adverse events. Among these, one study reported not having any adverse events.…”

“…Four of six studies evaluated the occurrence of adverse events. Among these, one study reported not having any adverse events. Reports of post‐operative complications included lip‐biting, cheek biting, pain at injection site, tooth tenderness and episodes of aching jaw.…”

Articaine in Endodontics: A Review.

“…[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. The articaine solution"s plasma half-life has been reported to be as short as 20 minutes, Although investigators have designed various clinical trials to compare articaine with a variety of other available anesthetic solutions, published data do not support a clear superiority of articaine in terms of anesthetic efficacy.…”