Comparison of Articaine and Lidocaine for Buccal Infiltration After Inferior Alveolar Nerve Block For Intraoperative Pain Control During Impacted Mandibular Third Molar Surgery

Abstract

In order to compare the efficacy of lidocaine and articaine for pain control during third molar surgery, 160 patients presenting bilateral asymptomatic impacted mandibular third molars were selected. They received 1.8 mL of 2% lidocaine with epinephrine 1:100,000 during inferior alveolar nerve block. In group 1 (n = 80), an infiltrative injection of 0.9 mL of 2% lidocaine with epinephrine 1:100,000 was performed in buccal-distal mucosa of the third molar. Group 2 (n = 80) received 0.9 mL of 4% articaine with epinephrine 1:100,000 in the contralateral side. All procedures were performed at the same visit, by a single operator, in a double-blind and parallel design. The duration of each surgery and the moment when the patient expressed pain were noted. Data were analyzed by nonpaired t test and chi-square test (alpha = 5%). Duration of surgery did not differ (p = .83) between Groups 1 (19.8 ± 2.3 minutes) and 2 (19.7 ± 3.0 minutes). Pain was expressed more in group 1 (26.3%) than in group 2 (10%) (odds ratio = 3.2, p = .0138). In both groups, tooth sectioning was the most painful event (p < .0001). No influence of gender (p = .85) or age (p = .96) was observed in pain response. Buccal infiltration of 4% articaine with epinephrine 1:100,000 showed more efficacy than 2% lidocaine with epinephrine 1:100,000 when used in combination with inferior alveolar nerve block in controlling intraoperative pain related to impacted mandibular third molar surgery.

Comparing Articaine brands: A randomized non-inferiority controlled trial

“…Pain measurement is always difficult to establish, because its perception and intensity are multifactorial, however the direct self-report is the most common in clinical practices [7].…”

Molar and Incisor Hypomineralization

“…Resin infiltration may be more effective, especially in areas with shallow defects. 33,[40][41][42][43] However, defects involving the entire width of enamel may require conventional approaches, such as composite resin restorations, particularly if the carious process has involved one or more surfaces with using self-etching adhesive. Full coverage restorations, such as stainless-steel crowns are good options for teeth with severely damaged surfaces.…”

“…[53][54][55][56] Extraction may be the treatment of choice for non-restorable teeth or those with poor prognoses, but in very young children, occlusal guidance must be utilized to ensure that the second permanent molars move in position of the first molar. 33,40,[53][54][55][56][57] Many factors must be considered, especially in cases involving the mandibular arch. The optimal timing for extractions is evidently between the ages of 8 and 10 years.…”

The anesthetic efficiency of retromolar infiltrations with two local anesthetic solutions of the same concentration in lower third molar surgery

“…The patients received the necessary information regarding the NRS in terms of pain intensity level ranging from 1 to 10, i.e. no pain (0), mild pain (1-3), moderate pain (4-6), and severe pain (7)(8)(9)(10). This was done before the initiation of the surgical procedure to help the patient score his or her pain reliably.…”

“…Moreover, Silva-Junior, Almeida, and Groppo reported on using the infiltration technique after inferior alveolar nerve injections to release intraoperative pain. They concluded that buccal infiltration after inferior alveolar injections enhances the effectiveness of inferior alveolar nerve injections that show a 10-26.3% failure rate [8].…”