Comparative investigations on the efficacy of articaine 4% (epinephrine 1:200,000) and articaine 2% (epinephrine 1:200,000) in local infiltration anaesthesia in dentistry—a randomised double-blind study

Abstract

A randomised double-blind study investigated 155 patients with tooth extractions in the mandibular and maxillary jaws for a loss of anaesthetic potency when reducing the concentration of the active in articaine solutions. Tests were performed on the preparations of articaine 4% with a 1:200,000 addition of epinephrine (Ultracain D-S) and articaine 2% with a 1:200,000 addition of epinephrine (Ultracain 2%-Suprarenin). Local infiltration anaesthesia was the chosen method of anaesthesia. The most noticeable difference observed between the two injection solutions concerned the duration of anaesthesia, which was significantly shortened under the low-dose solution. The 4% articaine solution did not prove superior in local anaesthetic effect. Articaine 2% with epinephrine 1:200,000, therefore, can be considered a suitable local anaesthetic for tooth extractions.

A Prospective, Randomized, Double-blind Comparison of Articaine and Lidocaine for Maxillary Infiltrations

“…However, with increased intensity of nerve stimulation, the compound action potential recovered for 2% articaine but not for 4% articaine. In a clinical study (33) comparing 2% and 4% articaine for infiltration anesthesia, the 4% articaine solution had a longer duration but not an increase in efficacy. It may be that factors other than the concentration may be responsible for the clinical efficacy of articaine.…”

Articaine: a review of the literature

“…When 2% and 4% articaine with 1:200,000 adrenaline (2% A200 and 4% A200 respectively) were used for extractions of maxillary and mandibular teeth, 4% A200 did not have a superior anaesthetic effect. 13,14 However an in vitro study showed that 2% and 4% articaine more effectively depressed the compound action potential of all A fibres in rat sensory nerves than 2% and 4% lignocaine and 3% mepivacaine could and 4% articaine was more effective than 2% articaine. 15 Currently it is not known why articaine is only manufactured in a 4% solution given that the limited data show no clinical advantage over a 2% preparation.…”

Efficacy of 4 % Articaine and 2 % Lidocaine: A clinical study

“…Potonick et al [45] reported that 2 % Articaine more effectively depresses the compound action potential of the A fibers in the isolated rat sural nerve than either 2 % or 4 % Lidocaine or 3 % Mepivacaine. Paessler et al [46] concluded that the 4 % Articaine solution did not prove superior in local anesthetic effect. Articaine 2 % with epinephrine 1:200,000, therefore, can be considered a suitable local anesthetic for tooth extractions.…”