Efficacy of 4% articaine <i>vs</i> 2% lidocaine in mandibular and maxillary block and infiltration anaesthesia in patients with irreversible pulpitis: a systematic review and meta-analysis

Miglani, Sanjay; Ansari, Irfan; Patro, Swadheena; Mohanty, Ankita; Mansoori, Shahnaz; Ahuja, Bhoomika; Karobari, Mohmed Isaqali; Shetty, Krishna Prasad; Saeed, Musab Hamed; Luke, Alexander Maniangat

doi:10.7717/peerj.12214

Cited by 7 publications

(3 citation statements)

References 46 publications

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“…[10,18] The main characteristics of lidocaine and articaine are summarized in Table 1. [19][20][21] In dental clinical applications, a small amount of adrenaline injection is usually added to lidocaine local anesthetic to reduce bleeding and blood oozing during the operation. However, it is difficult to master the standard preparation dose during clinical operations, and secondary pollution can easily occur.…”

Section: Comparison Of Articaine With Other Commonly Used Local Anest...mentioning

confidence: 99%

The potential of articaine as new generation of local anesthesia in dental clinics: A review

et al. 2022

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As a new drug for local dental anesthesia, articaine has become popular in the clinic in recent years. In this review, we describe the development of articaine, explain its mechanism of action, compare its efficacy with that of other commonly used local anesthetics in dental treatment, and summarize the application of articaine in special populations. In conclusion, the anesthetic efficacy of articaine in clinical dental treatment is better than that of lidocaine, and its safety is not statistically different from that of lidocaine. In particular, articaine has several advantages and can be selected flexibly for clinical use. Atecaine has great potential for wide application in dental clinics in the near future.

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Section: Comparison Of Articaine With Other Commonly Used Local Anest...mentioning

confidence: 99%

The potential of articaine as new generation of local anesthesia in dental clinics: A review

et al. 2022

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“…However, articaine, which is widely used in dentistry, is fundamentally different from other amide LAs because its thiophene ring has not been extensively researched. Physicochemical properties of articaine, such as increased lipid solubility and protein binding, are related to its increased anesthetic efficacy [ 7 8 9 ]. Commercially available articaine solutions for dentistry are usually provided with epinephrine at a 1:100000 or 1:200000 concentration and have low pH for the reasons explained above.…”

Section: Introductionmentioning

confidence: 99%

Anesthetic efficacy of buffered 4% articaine for mandibular first molar infiltration: a crossover clinical trial

Manta,

Dabarakis,

Lillis

et al. 2023

J Dent Anesth Pain Med

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Background The limited studies on the effect of buffering on the clinical efficacy of articaine have reported controversial results. The purpose of this study was to clinically compare the pain of injection, anesthetic success, onset, and duration of pulpal anesthesia of buffered 4% articaine with epinephrine 1:100000 versus a non-buffered 4% articaine with epinephrine 1:100000 formulation for buccal infiltration of the mandibular first molar. Methods Sixty-three volunteers were enrolled in the study. All volunteers received two injections consisting of a single mandibular first molar buccal infiltration with 1.8 ml of 4% articaine with epinephrine 1:100000 and 1.8 ml of 4% articaine with epinephrine 1:100000 buffered with 8.4% sodium bicarbonate. The infiltrations were applied in two separate appointments spaced at least one week apart. After injection of the anesthetic solution at the examined site, the first molar was pulp-tested every 2 min for the next 60 min. Results Successful pulpal anesthesia was recorded in 69.8% of cases using non-buffered articaine solution and 76.2% of cases using buffered articaine solution, with no significant difference between the formulations (P = 0.219). The mean time of anesthesia onset for the volunteers with successful anesthetic outcome in both formulations (n = 43) was 6.6 ± 1.6 min for the non-buffered articaine solution and 4.5 ± 1.6 min for the buffered solution, which differed significantly (P = 0.001). In the same volunteers, the mean duration of pulpal anesthesia was 28.4 ± 7.1 min for non-buffered articaine solution and 30.2 ± 8.5 min for buffered articaine solution, with no significant difference between the formulations (P = 0.231). Considering the pain of injection, regardless of the anesthetic success, the mean values of VAS were 11.3 ± 8.2 mm for the non-buffered articaine solution and 7.8 ±6.5 mm for the buffered articaine solution, which differed significantly (P = 0.001 < 0.05). Conclusion According to the present study, 4% articaine with epinephrine can benefit from buffering and provide better anesthetic behavior, with improved onset and less pain during injection.

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“…Among the available techniques, intraosseous and intra-ligamentary techniques posed a viable method to increase the success rate of failed IANB [ 19 , 20 ]. The need for specialized devices and their hemodynamic effects on the supplementary intraosseous process made practitioners opt for intra-ligamentary methods to perform painless intraoral procedures [ 9 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

A Prospective Clinical Study Evaluating the Efficacy of Intra-Ligamentary Anesthetic Solutions in Mandibular Molars Diagnosed as Symptomatic Irreversible Pulpitis with Symptomatic Apical Periodontitis

et al. 2022

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Accomplishing painless endodontic treatment, especially in the mandibular molar region, is challenging. Hence, the aim of the study was to compare the efficacy of 2% lidocaine and 4% articaine when used as supplemental intra-ligamentary (IL) anesthesia in mandibular molars having symptomatic irreversible pulpitis with symptomatic apical periodontitis after failed Inferior Alveolar Nerve Block (IANB) injection. In this prospective study, one-hundred and forty-seven adult patients diagnosed with irreversible pulpitis in a mandibular tooth were included who received IANB with 1.8 mL of 2% lidocaine with 1:100,000 epinephrine. Patients who experienced pain were recorded using the Heft–Parker visual analog scale (HP-VAS score ≥ 55 mm) and received supplement intra-ligament injection with either4% articaine or 2% lidocaine with 1:100,000 epinephrine. Supplementary intra-ligament injections resulted in 82.6% and 91.3% of profound anesthesia in the first molar region for 2% lidocaine and 4% articaine, respectively. Similarly, an additional IL injection of articaine success percent (78.9%) in the second molar region was higher than lidocaine (63.1%). The overall success ratio revealed no significant difference in achieving profound anesthesia of either solution. In this study population, there was no difference in the success ratio of anesthesia between 2% lidocaine and 4% articaine when used as supplemental IL injection.

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Efficacy of 4% articaine vs 2% lidocaine in mandibular and maxillary block and infiltration anaesthesia in patients with irreversible pulpitis: a systematic review and meta-analysis

Cited by 7 publications

References 46 publications

The potential of articaine as new generation of local anesthesia in dental clinics: A review

The potential of articaine as new generation of local anesthesia in dental clinics: A review

Anesthetic efficacy of buffered 4% articaine for mandibular first molar infiltration: a crossover clinical trial

A Prospective Clinical Study Evaluating the Efficacy of Intra-Ligamentary Anesthetic Solutions in Mandibular Molars Diagnosed as Symptomatic Irreversible Pulpitis with Symptomatic Apical Periodontitis

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