Comparing the Efficacy of Articaine and Lignocaine in Maxillary Irreversible Pulpitis: A Randomized Triple Blind Study
DOI:
https://doi.org/10.47489/szmc.v38i3.481Keywords:
Endodontics, irreversible pulpitis, efficacyAbstract
Introduction: Effective pain control during endodontic treatment is a mandatory component of patient care. The most commonly used anesthetic agent is lignocaine.
Aims & Objectives: The objective of this study is to compare the efficacy of Articaine and Lignocaine in maxillary irreversible pulpitis cases in terms of pain management.
Place and Duration of Study: The study was conducted in the outpatient department of Operatives Dentistry, Azra Naheed Dental College, The Superior University Lahore, Pakistan during 2023.
Material & Method: The present study is a triple-blind, randomized controlled trial in which 75 patients were selected by non-probability sampling. Patients were randomized into Group A and Group B. For both groups, the drugs were delivered using a standard aspirating syringe with a sterile single-use 27G 0.40 X 21mm disposable dental needle. For buccal vestibular local infiltration, the drug was administered at the buccal vestibule supra periosteal adjacent to the tooth to be endodontically treated at a rate of approximately 1ml. Ethical approval was taken from the IRB. Data was analyzed through SPSS version 24.
Results: A significant difference in anesthetic effect between 4% Articaine and 2% Lignocaine following an infiltration injection for maxillary first molars with irreversible pulpitis was found with a p-value of <0.001.
Conclusion: 4% Articaine is more efficacious than 2% lignocaine in irreversible pulpitis cases and can be used to produce desired analgesic effect.
References
Ahmed HMA, Nagendrababu V, Duncan HF, Peters OA, Dummer PMJIEJ. Developing a consensus-based glossary of controversial terms in Endodontology. 2023;56(7).
Saralaya S, Adirajaiah SB, Anehosur VJJoM, Surgery O. 4% articaine and 2% lignocaine for surgical removal of third molar by mandibular nerve block: A randomized clinical trial for efficacy and safety. 2019;18:405-11.
Zehravi M, Maqbool M, Ara IJTIJoN, Dietetics. An update on pain control in conservative dentistry and endodontics: a review. 2022:114-25.
Walton RE, Torabinejad M, Bakland LK. Endodontics. Principles and Practice (10th ed) St Louis, Missouri: Elsevier. 2009.
Jeske AH. Local anesthetics: special considerations in endodontics. The Journal of the Tennessee Dental Association. 2003;83(2):14-8.
Malamed SF, Gagnon S, Leblanc D. A comparison between articaine HCl and lidocaine HCl in pediatric dental patients. Pediatric dentistry. 2000;22(4):307-11.
Rossaint R, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E, et al. The European guideline on management of major bleeding and coagulopathy following trauma. Critical care. 2016;20:1-55.
Claffey E, Reader A, Nusstein J, Beck M, Weaver J. Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis. Journal of endodontics. 2004;30(8):568-71.
Rosenberg PA. Clinical strategies for managing endodontic pain. Endodontic Topics. 2002;3(1):78-92.
Brandt RG, Anderson PF, McDonald NJ, Sohn W, Peters MC. The pulpal anesthetic efficacy of articaine versus lidocaine in dentistry: a meta-analysis. Journal of the American Dental Association (1939). 2011;142(5):493-504.
Hori A, Poureslami HR, Parirokh M, Mirzazadeh A, Abbott P. The ability of pulp sensibility tests to evaluate the pulp status in primary teeth. International Journal of Paediatric Dentistry. 2011;21(6):441-5.
Hargreaves KM, Cohen S. Cohen's pathways of the pulp: Elsevier; 2010.
Simpson M, Drum M, Nusstein J, Reader A, Beck M. Effect of combination of preoperative ibuprofen/acetaminophen on the success of the inferior alveolar nerve block in patients with symptomatic irreversible pulpitis. Journal of endodontics. 2011;37(5):593-7.
Parirokh M, Ashouri R, Rekabi AR, Nakhaee N, Pardakhti A, Askarifard S, et al. The effect of premedication with ibuprofen and indomethacin on the success of inferior alveolar nerve block for teeth with irreversible pulpitis. Journal of endodontics. 2010;36(9):1450-4.
Katz S, Drum M, Reader A, Nusstein J, Beck M. A prospective, randomized, double-blind comparison of 2% lidocaine with 1:100,000 epinephrine, 4% prilocaine with 1:200,000 epinephrine, and 4% prilocaine for maxillary infiltrations. Anesthesia progress. 2010;57(2):45-51.
Isen D. Articaine: pharmacology and clinical use of a recently approved local anesthetic. Dentistry today. 2000;19(11):72-7.
Kanaa MD, Whitworth JM, Meechan JG. A comparison of the efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine in achieving pulpal anesthesia in maxillary teeth with irreversible pulpitis. Journal of endodontics. 2012;38(3):279-82.
Liew AKC, Yeh Y-C, Abdullah D, Tu Y-KJRD, Endodontics. Anesthetic efficacy in vital asymptomatic teeth using different local anesthetics: a systematic review with network meta-analysis. 2021;46(3).
Wang Y-H, Wang D-R, Liu J-Y, Pan JJods. Local anesthesia in oral and maxillofacial surgery: a review of current opinion. 2021;16(4):1055-65.
Miglani S, Ansari I, Patro S, Mohanty A, Mansoori S, Ahuja B, et al. 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. PeerJ. 2021;9.
Ashraf H, Kazem M, Dianat O, Noghrehkar F. Efficacy of articaine versus lidocaine in block and infiltration anesthesia administered in teeth with irreversible pulpitis: a prospective, randomized, double-blind study. Journal of endodontics. 2013;39(1):6-10.
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. Journal of endodontics. 2015;41(11):1784-94.
Srinivasan N, Kavitha M, Loganathan CS, Padmini G. Comparison of anesthetic efficacy of 4% articaine and 2% lidocaine for maxillary buccal infiltration in patients with irreversible pulpitis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2009;107(1):133-6.
Evans G, Nusstein J, Drum M, Reader A, Beck M. A prospective, randomized, double-blind comparison of articaine and lidocaine for maxillary infiltrations. Journal of endodontics. 2008;34(4):389-93.
Reader AW, Nusstein JM, Hargreaves KM. Local anesthesia in endodontics. Cohen's Pathways of the Pulp. 2011:691-719.
Ingle JI, Walton RE, Malamed SF, Coil JM, Khademi J, Kahn F. Preparation for endodontic treatment. Endodontics. 2002;5:357-404.
Hosseini HR, Parirokh M, Nakhaee N, Abbott PV, Samani S. Efficacy of articaine and lidocaine for buccal infiltration of first maxillary molars with symptomatic irreversible pulpitis: a randomized double-blinded clinical trial. Iranian endodontic journal. 2016;11(2):79.
Atasoy Ulusoy Ö, Alaçam T. Efficacy of single buccal infiltrations for maxillary first molars in patients with irreversible pulpitis: a randomized controlled clinical trial. International Endodontic Journal. 2014;47(3):222-7.
Ramachandran A, Khan SIR, Mohanavelu D. The efficacy of pre-operative oral medication of paracetamol, ibuprofen, and aceclofenac on the success of maxillary infiltration anesthesia in patients with irreversible pulpitis: A double-blind, randomized controlled clinical trial. Journal of Conservative Dentistry: JCD. 2012;15(4):310.
Parirokh M, Abbott PV. Various strategies for pain-free root canal treatment. Iranian endodontic journal. 2014;9(1):1.
Katyal V. The efficacy and safety of articaine versus lignocaine in dental treatments: a meta-analysis. Journal of dentistry. 2010;38(4):307-17.
Brandt RG, Anderson PF, McDonald NJ, Sohn W, Peters MC. The pulpal anesthetic efficacy of articaine versus lidocaine in dentistry: a meta-analysis. The Journal of the American Dental Association. 2011;142(5):493-504.
Lawaty I, Drum M, Reader A, Nusstein J. A prospective, randomized, double-blind comparison of 2% mepivacaine with 1:20,000 levonordefrin versus 2% lidocaine with 1:100,000 epinephrine for maxillary infiltrations. Anesthesia progress. 2010;57(4):139-44.
Noguchi T, Odaka K, Fukuda K-iJPR, Management. Clinical Application of Inferior Alveolar Nerve Block Device for Safe and Secure IANB by Any Operator. 2023;2023(1):1021918.
Arce AM. Articaine Local Infiltration Vs Lidocaine IANB for Restoration of First Permanent Molars in Children: University of Illinois at Chicago; 2019.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Proceedings
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a 