Comparison of anesthetic efficacy between oral infiltration with 4% articaine and inferior alveolar nerve block with 2% lidocaine: a prospective, randomized, double-blind clinical trial
DOI:
https://doi.org/10.33448/rsd-v10i11.19376Keywords:
Local anesthesia; Dental leakage; Dentistry; Nerve block.Abstract
For analgesia of posterior mandibular teeth, the most used anesthetic technique is the blockade of the inferior alveolar and lingual nerves, despite its relevant clinical failures. The aim of the present study was to compare the anesthetic efficacy of supraperiosteal infiltration with 4% articaine (INFILT) compared to inferior alveolar nerve block with 2% lidocaine (BNAI), both with 1:100,000 epinephrine, in lower posterior teeth. Sixty volunteers of both genders were selected, with indication for Black Class I or II restorations in mandibular posterior dental elements. The electric pulp tester device was used to evaluate the following parameters: pulp onset time (time from the end of the injection to the first non-sensing measurement), duration of the pulp anesthetic effect (time between the first and last non-sensing measurements) and anesthetic success (minimum of two consecutive measurements without sensitivity). Pain during the technique was measured using an 11-point boxed pain scale. The success rate presented by INFILT was higher than that of BNAI (p=0.0149). On the other hand, no significant differences were found with regard to latency time (p=0.4755), duration of pulpal anesthetic effect (p=0.1381) and pain on puncture and injection (p=0.9256). The rate of postoperative complications was 36.7% in both groups, all of which were classified as having low severity, ensuring clinical safety for the use of both techniques. Infiltration with articaine had a higher success rate compared to inferior alveolar nerve block with lidocaine. Once local anesthesia was achieved, there were no differences in the duration of effect between the two techniques.
References
Abu-Melha, A. S. et al. (2018). Anesthetic Efficacy of 4 % Articaine Versus 2 % Lidocaine in Lower Central Incisors - A Comparative Study. Dentistry. 5(4), 34–36.
Batista da Silva, C., Berto, L. A., Volpato, M. C., Ramacciato, J. C., Motta, R. H. L., Ranali, J., & Groppo, F. C. (2010). Anesthetic Efficacy of Articaine and Lidocaine for Incisive/Mental Nerve Block. Journal of Endodontics, 36(3), 438–441. https://doi.org/10.1016/j.joen.2009.12.014
Collins, S. L., Moore, A. R., & McQuay, H. J. (1997). The visual analogue pain intensity scale: what is moderate pain im millimeters. Pain, 72, 95–97.
Corbett, I. P., Kanaa, M. D., Whitworth, J. M., & Meechan, J. G. (2008). Articaine Infiltration for Anesthesia of Mandibular First Molars. Journal of Endodontics, 34(5), 514–518. https://doi.org/10.1016/j.joen.2008.02.042
Haase, A., Reader, A., Nusstein, J., Beck, M., & Drum, M. (2008). Comparing anesthetic efficacy of articaine versus lidocaine as a supplemental buccal infiltration of the mandibular first molar after an inferior alveolar nerve block. Journal of the American Dental Association, 139(9), 1228–1235. https://doi.org/10.14219/jada.archive.2008.0338
Jensen, M. P., Karoly, P., & Braver, S. (1986). The measurement of clinical pain intensity: a comparison of six methods. Pain, 27(1), 117–126. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/3785962
Karapinar-kazandag, M., Tanalp, J., & Ersev, H. (2019). Effect of Premedication on the Success of Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis : A Systematic Review of the Literature. 2019.
Kaushik, M., & Moturi, K. (2018). Local Anaesthesia and Inferior Alveolar Nerve Block - A Never Ending Saga. 5(1), 1–5. https://doi.org/10.19080/JPCR.2018.05.555652
Malamed, S. F. (2013). Manual de anestesia local (6a). Rio de Janeiro: Elsevier.
Maljaei, E., Pourkazemi, M., Ghanizadeh, M., & Ranjbar, R. (2017). The efficacy of buccal infiltration of 4% articaine and psa injection of 2% lidocaine on anesthesia of maxillary second molars. Iranian Endodontic Journal, 12(3), 276–281. https://doi.org/10.22037/iej.v12i3.16464
Monteiro, M. R. F. P., Groppo, F. C., Haiter-Neto, F., Volpato, M. C., & Almeida, J. F. A. (2015). 4% articaine buccal infiltration versus 2% lidocaine inferior alveolar nerve block for emergency root canal treatment in mandibular molars with irreversible pulpits: A randomized clinical study. International Endodontic Journal, 48(2), 145–152. https://doi.org/10.1111/iej.12293
Nydegger, B., Nusstein, J., Reader, A., Drum, M., & Beck, M. (2014). Anesthetic comparisons of 4% concentrations of articaine, lidocaine, and prilocaine as primary buccal infiltrations of the mandibular first molar: A prospective randomized, double-blind study. Journal of Endodontics, 40(12), 1912–1916. https://doi.org/10.1016/j.joen.2014.08.001
Oleson, M., Drum, M., Reader, A., Nusstein, J., & Beck, M. (2010). Effect of preoperative ibuprofen on the success of the inferior alveolar nerve block in patients with irreversible pulpitis. Journal of Endodontics, 36(3), 379–382. https://doi.org/10.1016/j.joen.2009.12.030
Poorni, S., Veniashok, B., Senthilkumar, A. D., Indira, R., & Ramachandran, S. (2011). Anesthetic efficacy of four percent articaine for pulpal anesthesia by using inferior alveolar nerve block and buccal infiltration techniques in patients with irreversible pulpitis: A prospective randomized double-blind clinical trial. Journal of Endodontics, 37(12), 1603–1607. https://doi.org/10.1016/j.joen.2011.09.009
Rathi, N. V., Khatri, A. A., Agrawal, A. G., M, S. B., Thosar, N. R., & Deolia, S. G. (2019). Anesthetic Efficacy of Buccal Infiltration Articaine versus Lidocaine for Extraction of Primary Molar Teeth. Anesthesia Progress, 66(1), 3–7. https://doi.org/10.2344/anpr-65-04-02
Ravi, B. S., Vinay, K., Uday, M. K., & Uppada, K. (2018). Comparison of Efficacy of Halstead , Vazirani Akinosi and Gow Gates Techniques for Mandibular Anesthesia. Journal of Maxillofacial and Oral Surgery. https://doi.org/10.1007/s12663-018-1092-5
Rayati, F., Noruziha, A., & Jabbarian, R. (2018). Efficacy of buccal infiltration anaesthesia with articaine for extraction of mandibular molars: a clinical trial. British Journal of Oral and Maxillofacial Surgery, 56(7), 607–610. https://doi.org/10.1016/j.bjoms.2018.06.012
Srinivasan, M. R., Poorni, S., Nitharshika, Y., Diana, D., & Duraivel, D. (2017). Articaine buccal infiltration versus lignocaine inferior alveolar block for pulpal anaesthesia in mandibular second premolars – Randomized control double blinded clinical trial. Journal of Pierre Fauchard Academy (India Section), 31(2–4), 79–83. https://doi.org/10.1016/j.jpfa.2017.03.005
Tortamano, I. P., Siviero, M., Lee, S., Sampaio, R. M., Simone, J. L., & Rocha, R. G. (2013). Onset and duration period of pulpal anesthesia of articaine and lidocaine in inferior alveolar nerve block. Brazilian Dental Journal, 24(4), 371–374. https://doi.org/10.1590/0103-6440201302072
Venkat Narayanan, J., Gurram, P., Krishnan, R., Muthusubramanian, V., & Sadesh Kannan, V. (2017). Infiltrative local anesthesia with articaine is equally as effective as inferior alveolar nerve block with lidocaine for the removal of erupted molars. Oral and Maxillofacial Surgery, 21(3), 295–299. https://doi.org/10.1007/s10006-017-0628-z
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