Evaluation of anesthetic efficacy of 4% articaine as buccal infiltration vs 2% lidocaine as IANB in the mandibular 1st molar with irreversible pulpitis

ABSTRACT

The purpose of this prospective, randomized, study was to compare the anesthetic efficacy of 4% articaine with 1100,000 epinephrine and 2% lidocaine with 1200,000 epinephrine for buccal infiltration and inferior alveolar nerve block respectively in patients experiencing irreversible pulpitis in permanent mandibular first molars. Sixty emergency patients diagnosed with irreversible pulpitis of a mandibular first molar ran-domly divided into two groups. Thirty patients received buccal infiltration of 1.7 ml of 4% articaine with 1100,000 epinephrine and thirty patients received standard inferior alveolar nerve block with 1.8 ml of 2% lidocaine with 1200,000 epinephrine. Endodontic access was begun 10 minutes after solution deposition, success [anesthetic efficacy] was defined as none or mild pain [Visual Analogue Scale recordings] on endodontic access preparation or pulp extirpation. Twenty-two patients out of 30 did not experience pain with 4% articaine [success = 52.4%] and 20 out of 30 patients did not experience pain in 2% lignocaine group [success = 47.6%]. There was no statistically significant difference between the articaine formulation as buccal infiltration and lidocaine formulation as IANB with regard to anesthetic success [p value =0.220]. Even though buccal infiltration of 4% articaine and IANB of 2% lidocaine were equally effective, buccal infiltration can be considered a viable substitute in IANB for anesthetizing mandibular first molar with irreversible pulpitis