Efficacy of 2% lidocaine and 4% articaine in mandibular molars with different pulp diagnoses in the mandibular technique

Authors

  • Adel Alfonso Martínez-Martínez Universidad de Cartagena
  • Evelyn Freyle-Granados Universidad de Cartagena
  • Natalia Senior-Carmona Universidad de Cartagena

DOI:

https://doi.org/10.17533/udea.rfo.v30n1a1

Keywords:

Dental pulp, Pulpitis, Local anesthesia, Lidocaine, Articaine

Abstract

Introduction: the inferior alveolar dental nerve block is the method most commonly used by endodontists to achieve local anesthesia during treatments. This study compared the efficacy of two anesthetic solutions: 2% lidocaine with 1:80,000 epinephrine and 4% articaine with 1:100,000 epinephrine in patients with different pulp diagnoses requiring endodontic treatment. Method: an interventional, randomized clinical trial. The sample included 36 patients who were treated at the postgraduate endodontics service at the Universidad de Cartagena in the year 2016. Descriptive statistics and the Chi2 test were used for data analysis, using a limit of 0.05. Results: articaine showed a greater anesthetic effect in vestibular mucosa (88.9%) and tip of tongue (55.6%), compared with lidocaine. The rates of anesthetic success in the lidocaine and articaine groups were 5.6% and 22.2% respectively, but this difference was not statistically significant (p = 0.633). In teeth with normal pulp, the efficacy was 27.3%, and this value considerably decreased in teeth with asymptomatic and symptomatic irreversible pulpitis, with percentages of 5.8% and 12.5% respectively, although this difference was not statistically significant (p = 0.276). Conclusions: no statistically significant differences were found in the anesthetic efficacy of 2% lidocaine and 4% articaine in lower molars with vital pulp. However, articaine showed a better rate of anesthetic success. No statistically significant differences were found when comparing the anesthetic efficacy in molars with normal pulp and molars with inflamed pulp—although the percentage of success in normal pulp was greater than in teeth with irreversible pulpitis.

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Author Biographies

Adel Alfonso Martínez-Martínez, Universidad de Cartagena

Assistant Professor, GITOUC Group, School of Dentistry, Universidad de Cartagena

Evelyn Freyle-Granados, Universidad de Cartagena

DDS, Specialist in Endodontics, Postgraduate program in Endodontics, School of Dentistry, Universidad de Cartagena 

Natalia Senior-Carmona, Universidad de Cartagena

DDS, Specialist in Endodontics, Postgraduate program in Endodontics, School of Dentistry, Universidad de Cartagena

References

Filo K, Schneider T, Kruse AL, Locher M, Grätz KW, Lübbers HT. Frequency and anatomy of the retromolar

canal – implications for the dental practice. Swiss Dent J. 2015; 125(3): 278-92.

AlHindi M, Rashed B, AlOtaibi N. Failure rate of inferior alveolar nerve block among dental students and

interns. Saudi Med J. 2016; 37(1): 84-9. DOI: https://doi.org/10.15537/smj.2016.1.13278

Aggarwal V, Jain A, Kabi D. Anesthetic efficacy of supplemental buccal and lingual infiltrations

of articaine and lidocaine after an inferior alveolar nerve block in patients with irreversible pulpitis. J Endod. 2009;

(7): 925-9. DOI: https://doi.org/10.1016/j.joen.2009.04.012

Yadav M, Grewal MS, Grewal S, Deshwal P. Comparison of preoperative oral ketorolac on anesthetic

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.

; 41(11): 1773-7. DOI: https://doi.org/10.1016/j.joen.2015.06.008

Veena A, Mitry P. Anaesthetic Efficacy of 4% articaine mandibular

buccal infiltration compared to 2% lignocaine inferior alveolar nerve block in children with irreversible pulpitis. J Clin Diagn Res. 2015; 9(4): 65-7.

Aggarwal V, Singla M, Miglani S. Comparative evaluation of anesthetic efficacy of 2% lidocaine, 4%

articaine, and 0.5% bupivacaine on inferior alveolar nerve block in patients with symptomatic irreversible

pulpitis:

a prospective, randomized, double-blind clinical trial. J Oral Facial Pain Headache. 2017; 31(2):

-8. DOI: https://doi.org/10.11607/ofph.1642

Kanaa MD, Whitworth JM, Meechan JG. A prospective randomized trial of different supplementary local

anesthetic techniques after failure of inferior alveolar nerve block in patients with irreversible pulpitis in

mandibular teeth. J Endod. 2012; 38(4): 421-5. DOI: https://doi.org/10.1016/j.joen.2011.12.006

Marroquín TY, García CC. Guidelines for clinical diagnosis of pulp and periapical pathologies. Adapted

and updated from the “Consensus Conference Recommended Diagnostic Terminology” published by the

American Association of Endodontists (2009). Rev Fac Odontol Univ Antioq. 2015; 26(2): 398-424.

Sood R, Hans M-K, Shetty S. Comparison of anesthetic efficacy of 4% articaine with 1: 100,000 epinephrine

and 2% lidocaine with 1: 80,000 epinephrine for inferior alveolar nerve block in patients with irreversible

pulpitis. J Clin Exp Dent. 2014; 6(5): 520-3.

Fowler S. Anesthetic 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;

(3): 390-2. DOI: https://doi.org/10.1016/j.joen.2015.12.025

Aggarwal V, Singla M, Subbiya A, Vivekanandhan P, Sharma V, Sharma R et al. Effect of preoperative

pain on inferior alveolar nerve block. Anesth Prog. 2015; 62(4): 135-9. DOI: https://doi.org/10.2344/15-00019.1

Claffey E, Reader A, Nusstein J. Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients

with irreversible pulpitis. J Endod. 2004; 30: 568-71.

Gouws P, Galloway P, Jacob J. Comparison of articaine and bupivacaine/lidocaine for sub-Tenon’s

anaesthesia in cataract extraction. J Anaesth. 2004; 92: 228-30.

Berlin J, Nusstein J, Reader A, Beck M, Weaver J. Efficacy of articaine and lidocaine in a primary

intraligamentary injection administered with a computer-controlled local anesthetic delivery system.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 99: 361-66. DOI: https://doi.org/10.1016/j.

tripleo.2004.11.009

Al-Kahtani A. Effect of long acting local anesthetic on postoperative pain in teeth with irreversible pulpitis:

Randomized clinical trial. J Pharm Saudi. 2014; 22: 39-42.

Elad S. The cardiovascular effect of local anesthesia with articaine plus 1:200,000 adrenalin versus lidocaine

plus 1:100,000 adrenalin in medically compromised cardiac patients: a prospective, randomized, double

blinded study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105: 725-30.

Kämmerer PW, Palarie V, Daubländer M. Comparison of 4% articaine with epinephrine (1:100,000) and

without epinephrine in inferior alveolar block for tooth extraction: double-blind randomized clinical trial of

anesthetic efficacy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2012; 113: 495-9.

Colombini BL, Modena KC, Calvo AM, Sakai VT, Giglio FP, Dionísio TJ. Articaine and mepivacaine efficacy

in postoperative analgesia for lower third molar removal: a double-blind, randomized, crossover study.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102: 169-74. DOI: https://doi.org/10.1016/j.

tripleo.2005.09.003

Mikesell P, Nusstein J, Reader A, Beck M, Weaver J. A comparison of articaine and lidocaine for inferior

alveolar nerve blocks. J Endod. 2005; 31: 265-70.

Nusstein J, Reader A, Beck FM. Anesthetic efficacy of different volumes of lidocaine

with epinephrine for

inferior alveolar nerve blocks. Gen Dent. 2002; 50: 372-5.

Kambalimath DH, Dolas RS, Kambalimath HV, Agrawal SM. Efficacy of 4% Articaine and 2% Lidocaine: A

clinical study. J Maxillofac Oral Surg. 2012; 12(1): 3-10. DOI: https://doi.org/10.1007/s12663-012-0368-4

Oliveira PC, Volpato MC, Ramacciato JC, Ranali J. Articaine and lignocaine efficiency in infiltration

anaesthesia: a pilot study. Br Dent J. 2004; 197(1) 45-6. DOI: https://doi.org/10.1038/sj.bdj.4811422

Kanaa MD, Whitworth JM, Corbett IP, Meechan JG. Articaine buccal infiltration enhances the effectiveness

of lidocaine inferior alveolar nerve block. Int Endod J. 2009; 42(3) 238-46. DOI: https://doi.org/10.1111/

j.1365-2591.2008.01507.x

Aggarwal V, Singla M, Rizvi A, Miglani S. Comparative evaluation of local infiltration of articaine,

articaine plus ketorolac, and dexamethasone on anesthetic efficacy of inferior alveolar nerve block with

lidocaine in patients with irreversible pulpitis. J Endod. 2011; 37(4) 445-9. DOI: https://doi.org/10.1016/j.

joen.2011.01.016

Evans G, Nusstein J, Drum M, Reader A, Beck M. A prospective, randomized, double-blind comparison

of articaine and lidocaine for maxillary infiltrations. J Endod. 2008; 34(4) 389-93. DOI: https://doi.

org/10.1016/j.joen.2008.01.004

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Published

2018-12-20

How to Cite

Martínez-Martínez, A. A., Freyle-Granados, E., & Senior-Carmona, N. (2018). Efficacy of 2% lidocaine and 4% articaine in mandibular molars with different pulp diagnoses in the mandibular technique. Revista Facultad De Odontología Universidad De Antioquia, 30(1), 5–13. https://doi.org/10.17533/udea.rfo.v30n1a1