A Comparative Evaluation of Anesthetic Effectiveness of 4% Articaine vs 0.5% Bupivacaine for Lower Molar Tooth Extraction

Abstract

Background: Safe and efficient pain control is essential for today's dental practice. This randomized controlled study was conducted to evaluate the effectiveness of 0.5% bupivacaine with 4% articaine in lower molar tooth extraction.Methods: One hundred subjects were classified into two groups, with 50 samples for each. Group A participants were managed with 0.5% bupivacaine with 1:200,000 epinephrine and group B participants with 4% articaine with 1:100,000 epinephrine for mandibular first and second molar extraction. Criteria such as onset and duration of anesthesia, pain throughout the procedure, pain during injection, and pain after the procedure were evaluated. Systolic and diastolic blood pressure (mmHg) and heart rate (per minute) were evaluated for all participants.Results: There was a faster onset (53.2 vs 83.1 s) and lesser duration of action (216.6 vs 298.4 min) with articaine (group B) compared to bupivacaine (group A). Thirty-eight (76.0%) participants in group A and 44 (88.0%) participants in group B did not require re-anesthesia, whereas 12 (24%) participants in group A and six (12%) participants in group B required one-time re-anesthesia and it was insignificant.Conclusion: Articaine has a faster onset but a relatively lower duration of action and requires statistically insignificant but lower re-anesthesia. As a result, articaine anesthesia can be efficiently recommended in oral surgical techniques.