COMPARISON OF ANAESTHETIC EFFICACY OF ARTICAINE AND LIDOCAINE IN NONSURGICAL ENDODONTIC TREATMENT OF PERMANENT MANDIBULAR MOLARS WITH SYMPTOMATIC IRREVERSIBLE PULPITIS. A RANDOMIZED CLINICAL TRIAL

Authors

  • Quratulain Khan Shifa College of Dentistry Islamabad Shifa Tameer e Millat University
  • Nouman Noor Rawal Institute of Health Sciences
  • Nouman Anayat Rawal Institute of Health Sciences, Islamabad
  • Tayyaba Sehrish Khan University of Gothenburg, Sweden
  • Manzoor Ahmed Rawal Institute of Health Sciences, Islamabad

Abstract

Background: Inferior Alveolar Nerve Block (IANB) with Buccal Infiltration (BI) anaesthesia is required to completely anesthetize the mandibular molars with symptomatic irreversible pulpitis. 4% Articaine and 2% Lidocaine provide local anaesthesia during the nonsurgical endodontic treatment of mandibular molars with symptomatic irreversible pulpitis. Objective of the study was to compare the effect of Articaine and Lidocaine in the combination of Inferior alveolar nerve block with buccal infiltration anaesthesia during the nonsurgical endodontic treatment of mandibular molars with symptomatic Irreversible Pulpitis. Method: One hundred and sixty participants with Symptomatic Irreversible Pulpitis of permanent mandibular molars were divided randomly in two groups. Group A was given Articaine 4% IANB along with BI whereas group B was given Lidocaine 2%. Pain was assessed after 15 minutes of administration of local anaesthesia. Anaesthetic success of the agents is defined as, absence of pain or mild pain first during the access cavity preparation then instrumentation of the canals of tooth. Chi-square test was applied to analyse data for statistical significance. Results: Anaesthetic success of Articaine was 96.2% during access cavity preparation compared to Lidocaine (86.2%). Success during instrumentation of canals was also found to be high in Articaine (90.2%) compared to Lidocaine (76.2%). This difference of anaesthetic efficacy between Articaine and Lidocaine was found statistically significant. (p=0.02) Conclusion: Articaine is found to be better than Lidocaine regarding anaesthetic efficacy and hence, it can be a safer alternative to Lidocaine.

Author Biographies

Quratulain Khan, Shifa College of Dentistry Islamabad Shifa Tameer e Millat University

Senior Registrar Operative Dentistry & Endodontics Department

Nouman Noor, Rawal Institute of Health Sciences

Assosciate ProfessorOperative Dentistry & Endodontics Department

Nouman Anayat, Rawal Institute of Health Sciences, Islamabad

Assistant Professor Operative Dentistry & Endodontics Department

Tayyaba Sehrish Khan, University of Gothenburg, Sweden

Dental surgeon Swedish HospitalFolktandvården vara grästorp, Sweden

Manzoor Ahmed, Rawal Institute of Health Sciences, Islamabad

Professor  Operative Dentistry & Endodontics Department

References

Ashraf H, Kazem M, Dianat O, Noghrehkar F. Efficacy of Articaine versus Lidocaine in Block and Infiltration Anaesthesia Administered in Teeth with Irreversible Pulpitis: A Prospective, Randomized, Double-blind Study. J Endod 2013;39(1):6–10.

Subbiya A, Pradeepkumar AR, Vivekanandhan O, Karthick A. Comparative Efficacy Evaluation of Articaine as Buccal Infiltration and Lignocaine as IANB in the Mandibular first Molar with Irreversible Pulpitis. Indian J multidiscip Dent 2011;2(1):370–3.

Poorni S, Veniashok B, Senthilkumar AD, Indira R, Ramachandran S. Anaesthetic Efficacy of Articaine for Pulpal Anaesthesia by Using Inferior Nerve Block and Buccal Infiltration Techniques in Patients with Irreversible Pulpitis: A Prospective Randomized Double –blind Clinical Trail. J Endod 2011;37(12):1603–7.

Saatchi M, Farhad AR, Shenasa N, Haghighi SK. Effect of Sodium Bicarbonate Buccal Infiltration on the Success of Inferior Alveolar Nerve Block in Mandibular First Molars with Symptomatic Irreversible Pulpitis: A Prospective, Randomized Double-blind Study. J Endod 2016;42(10):1458–61.

Walton R, Vertucci F. Internal anatomy. Torabinejad M, Walton RE. Endodontics principles and practice. Saunders. 2009; p.142.

Rogers BS, Botero TM, McDonald NJ, Gardner RJ, Peters MC. Efficacy of articaine versus lidocaine as a supplemental buccal infiltration in mandibular molars with irreversible pulpitis: a prospective, randomized, double-blind study. J Endod 2014;40(6):753–8.

Saraf SP, Saraf PA, Kamatagi L, Hugar S, Tamgond S, Patil J. A comparative evaluation of anaesthetic efficacy of articaine 4% and lidocaine 2% with anterior middle superior alveolar nerve block and infraorbital nerve block: An in vivo study. J Conserv Dent 2016;19(6):527–31.

Brandt RG, Anderson PF, McDonald NJ, Sohn W, Peters MC. The pulpal anaesthetic efficacy of articaine versus lidocaine in dentistry: A meta-analysis. J Am Dent Assoc 2011;142(5):493–504.

Shapiro MR, McDonald NJ, Gardner RJ, Peters MC, Botero TM. Efficacy of Articaine versus Lidocaine in Supplemental Infiltration for Mandibular First versus Second Molars with Irreversible Pulpitis: A Prospective, Randomized, Double-blind Clinical Trial. J Endod 2018;44(4):523–8.

Shahi S, Rahimi S, Yavari HR, Ghasemi N, Ahmadi F. Success Rate of 3 Injection Methods with Articaine for Mandibular First Molars with Symptomatic Irreversible Pulpitis: A CONSORT Randomized Double-blind Clinical Trial. J Endod 2018;44(10):1462–6.

Bartlett G, Mansoor J. Articaine buccal infiltration vs lidocaine inferior dental block - a review of the literature. Br Dent J 2016;220(3):117–20.

Nydegger B, Nusstein J, Reader A, Drum M, Beck M. Anaesthetic Comparison of 4% concentration of Articaine, Lidocaine, and Prilocaine as Primary Buccal Infiltrations of the Mandibular First Molar: A Prospective Randomized, Double-blind Study. J Endod 2014;40(12):1912–6.

Ahmad ZH, Ravikumar H, Karale R, Preethanath RS, Sukumaran A. Study of the anaesthetic efficacy of inferior alveolar nerve block using articaine in irreversible pulpitis. J Contemp Dent Pract 2014;15(1):71–4.

Tortamano IP, Siviero M, Lee S, Sampaio RM, Simone JL, Rocha RG. Onset and Duration Period of Pulpal Anaesthesia of Articaine and Lidocaine in Inferior Alveolar Nerve Block. Braz Dent J 2013;24(4):371–4.

Meechan J. Articaine and lignocaine. Evid Based Dent 2011;12(1):21–2.

Argueta-Figueroa L, Arzate-Sosa G, Mendieta-Zeron H. Anaesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with symptomatic versus asymptomatic irreversible pulpitis. Gen Dent 2012;60(1):e39–43.

Badr N, Aps J. Efficacy of dental local anaesthetics: A review. J Dent Anesth Pain Med 2018;18(6):319–32.

Shadmehr E, Aminozarbian MG, Akhavan A, Mahdavian P, Davoudi A. Anaesthetic efficacy of lidocaine/clonidine for inferior alveolar nerve block in patients with irreversible pulpitis. Int Endod J 2017;50(6):531–9.

Malamed SF, Gagnon S, Leblanc D. Efficacy of articaine: A new amide local anaesthetic. J Am Dent Assoc 2000;131(5):635–42.

Kanaa MD, Whitworth JM, Meechan JG. A Prospective Randomized Trial of Different Supplementary Local Anaesthetic Techniques after Failure of Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis in Mandibular Teeth. J Endod 2012;38(4):421–5.

Fowler S, Drum M, Reader A, Beck M. Anaesthetic Success of an Inferior Alveolar Nerve Block and Supplemental Articaine Buccal Infiltration for Molars and Premolars in Patients with Symptomatic Irreversible Pulpitis. J Endod 2016;42(3):390–2.

Aggarwal V, Singla M, Rizvi A, Miglani S. Comparative evaluation of local infiltration of articaine, articaine plus ketorolac, and dexamethasone on anaesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis. J Endod 2011;37(4):445–9.

Yadav M, Grewal MS, Grewal S, Deshwal P. Comparison of Preoperative Oral Ketorolac on Anaesthetic Efficacy of Inferior Alveolar Nerve Block and Buccal and Lingual Infiltration with Articaine and Lidocaine in Patients with Irreversible Pulpitis: A Prospective, Randomized, Controlled, Double-blind Study. J Endod 2015;41(11):1773–7.

Kung J, McDonagh M, Sedgley CM. Does Articaine Provide an Advantage over Lidocaine in Patients with Symptomatic Irreversible Pulpitis? A Systematic Review and Meta-analysis. J Endod 2015;41(11):1784–94.

Downloads

Published

2021-04-23