Anesthetic Efficacy of Buccal Infiltration Articaine versus Lidocaine for Extraction of Primary Molar Teeth

Abstract

The aim of this study was to compare the efficacy of articaine versus lidocaine, both containing epinephrine, using a single buccal infiltration for extraction of primary molars.A total of 100 children requiring primary molar extraction received buccal infiltration using either 4% articaine or 2% lidocaine, both with epinephrine, with 50 children in each group. The Wong-Baker Facial Pain Scale (FPS) was used to evaluate pain perception subjectively. The heart rate and the blood pressure values were assessed objectively as an indirect measure of physiological pain perception. The Wilcoxon-Mann-Whitney test was used for comparing mean pain scores, heart rate, and blood pressure in both the groups. Single buccal infiltration with articaine was sufficient for achieving palatal or lingual anesthesia in all the children receiving it while all children in the lidocaine group required supplemental anesthesia. The mean FPS value was found to be higher in lidocaine group and was statistically significant. The mean heart rate recorded during the intervention was less than the mean baseline values in the articaine group, which was found to be statistically significant. For pediatric patients age 7 to 12 years, single buccal infiltration with 4% articaine with 1:100,000 epinephrine is more effective compared to 2% lidocaine with 1:80,000 epinephrine for primarly molar extraction.

Can single buccal infiltration with 4% articaine induce sufficient analgesia for the extraction of primary molars in children: a systematic literature review

“…Screening of titles and abstracts was carried out on the remaining 539 articles (after the duplicate removal). The full texts of the 13 potentially relevant papers were evaluated [6,8,[12][13][14][15][16][17][18][19][20][21][22], and 8 of them were excluded [6,8,[13][14][15]17,18,22]; the reasons for exclusion are presented in Table 1.…”

“…The studies by Rathi et al. [21] and Mittal et al [20] followed the double-blind design. The triple-blind design was followed in the studies by Kolli et al [16] and Massignan et al [19].…”

“…The triple-blind design was followed in the studies by Kolli et al [16] and Massignan et al [19]. [16,20], mandibular [12], or both [19,21].…”

“…The blinding of participants, personnel, and observers were carried out in all the studies, except in the study by Alzahrani et al [12]. Attrition bias was observed only in the study by Alzahrani et al [12]; the remaining four studies were free of attrition bias [16,[19][20][21]. Reporting bias was not observed in any of the included studies [12,16,[19][20][21].…”

“…In the study by Kolli et al[16], only maxillary primary molars were extracted; both maxillary and mandibular primary molars were extracted in the study by Rathi et al[21]. In both studies, the mean scores of procedural pain during extraction reported by the children were significantly lower in the single buccal infiltration of 4% articaine group than in the double infiltration of 2% lignocaine group (Kolli et al[16] FPS score: articaine, 0.73 ± 1.1, lignocaine, 1.20 ± 1.34, P > 0.05;Rathi et al[21] FPS score: articaine 1.52 ± 1.64, lignocaine, 5.60 ± 1.80, P > 0.05)[16,21]. Procedural pain reaction during extraction (observer reported pain response): Only the study by Kolli et al[16] evaluated the observer-reported pain scores using the FLACC scale for the above-mentioned comparison.…”