Inquiry

Articaine and lidocaine

Background

Each day dentists administer local anesthesia, usually with lidocaine or articaine. Articaine, the newer agent, allows more anesthetic to diffuse across the nerve membrane, which can increase its potency. Mandibular molars and/or premolars on one side of the jaw are normally anesthetized using an inferior alveolar nerve block (IANB). The process is very technique sensitive, however. Success rates have been variously reported as being as high as 92% or as low as 55%. A buccal infiltration (BI)

Methods

Studies comparing articaine BIs and lidocaine IANBs were identified through a search of the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases. Only studies using permanent mandibular molars were included. Two studies met the criteria—one by Corbett and one by Poorni.

Results

The Corbett study included 31 volunteers age about 23 years with a minimum of one vital lower first molar. Twenty-seven of the participants served in a concurrent IANB investigation as controls. Successful anesthesia was achieved using articaine BI by 70.4% of the subjects and using lidocaine IANB by 55.6% of the subjects.

The Poorni study included 156 healthy volunteers age 18 to 30 years with active pain in a mandibular molar and symptoms of irreversible pulpitis. The success rates were

Discussion

Articaine BIs are gaining acceptance among dentists for anesthetizing mandibular molar teeth because their administration is simple and they avoid iatrogenic damage to the inferior alveolar and lingual nerves. This study indicates that the results of articaine BIs and lidocaine IANBs are comparable.