Local Anaesthetic Efficacy of 4 % Articaine for Inferior Alveolar Nerve Block and Buccal Infiltration in Teeth with Irreversible Pulpitis - A Randomized, Double-Blind Clinical Trial

BACKGROUND Achieving profound pulpal anaesthesia with an inferior alveolar nerve block (IANB) in lower molars suffering irreversible pulpitis is difficult and quite challenging. In many instances, supplemental anaesthesia is required during endodontic therapy. The present study was done to evaluate the efficiency of 2 % lidocaine and 4 % articaine comparatively, as an inferior alveolar nerve block (IANB) and supplemental infiltration buccally in providing complete mandibular molar anaesthesia. METHODS This is a randomized double-blinded study. Sixty patients were categorized randomly into test group (n= 30) and control group (n= 30). Patients in the test group were anaesthetized with 4 % articaine (1:100,000 epinephrine dilution), and those in the control group were anaesthetized with 2 % lidocaine (1:80,000 epinephrine dilution). The Heft-Parker visual analog scale (HP-VAS) was utilized for rating patient’s pain during the treatment procedure. In case of pain after IANB, a supplemental buccal infiltration was given with the same anaesthetic used for IANB. Complete pain absence or mild pain was regarded as an anaesthetic efficacy, and moderate to severe pain was regarded as an anaesthetic failure. Recorded data was analyzed using the chi-square test and two proportion Z test. The set significance level was 0.05. RESULTS After an IANB, observed anaesthetic success was 56 % in the articaine (test) group and that in the lidocaine (control) group was 33 %. After buccal infiltration, it was 92 % in the articaine group and 75 % in the lidocaine group. The difference was not found significant between the two groups statistically following IANB and infiltration buccally. The overall success of articaine was 96 %, and lidocaine was 83 %. CONCLUSIONS Compared to 2 % lidocaine, 4 % articaine was found more efficient in achieving profound pulpal anaesthesia in mandibular molars suffering irreversible pulpitis after IANB and buccal infiltration though the difference was insignificant statistically. KEY WORDS Articaine, Lidocaine, Inferior Alveolar Nerve Block, Buccal Infiltration, Heft-Parker Visual Analog Scale, Irreversible Pulpitis

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Study of the Anesthetic Efficacy of Inferior Alveolar Nerve Block using Articaine in Irreversible Pulpitis

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1490 ◽

2014 ◽

Vol 15 (1) ◽

pp. 71-74 ◽

Cited By ~ 4

Author(s):

Zeeshan H Ahmad ◽

H Ravikumar ◽

Rupali Karale ◽

RS Preethanath ◽

Anil Sukumaran

Keyword(s):

Nerve Block ◽

Visual Analog Scale ◽

Inferior Alveolar Nerve ◽

Inferior Alveolar Nerve Block ◽

Analog Scale ◽

Cavity Preparation ◽

The Third ◽

Group 2 ◽

Buccal Infiltration ◽

Irreversible Pulpitis

ABSTRACT Aim The purpose of this study was to determine the anesthetic efficacy of inferior alveolar nerve block (IANB) using 4% articaine and 2% lidocaine supplemented with buccal infiltration. Materials and methods Forty five patients, diagnosed with irreversible pulpitis of a mandibular posterior tooth were included in the study. The first group of 15 patients received 2% lidocaine with 1:200000 epinephrine, the second group 2% lidocaine with 1: 80,000 epinephrine and the third group of 15 subjects received 4% articaine with 1:100000 epinephrine. During the access cavity preparation those patients who complained of pain received an additional buccal infiltration. The percentage of subjects who got profound anesthesia and failure to achieve anesthesia were calculated and tabulated using a visual analog scale. Results The results revealed that 87% of subjects who received 4% Articaine with 1:100,000 epinephrine got satisfactory anesthesia with inferior alveolar nerve block alone. Only 2 (13%) subjects received an additional buccal infiltration and none of the patients failed to obtain complete anesthesia with articaine. In comparison only 40% of subjects got complete anesthesia with 2% lidocaine with 1:200000 and 60% with 2% lidocaine with 1:80,000. Conclusion It can be concluded that 4% articaine can be used effectively for obtaining profound anesthesia for endodontic procedures in patients with irreversible pulpitis. How to cite this article Ahmad ZH, Ravikumar H, Karale R, Preethanath RS, Sukumaran A. Study of the Anesthetic Efficacy of Inferior Alveolar Nerve Block using Articaine in Irreversible Pulpitis. J Contemp Dent Pract 2014;15(1):71-74.

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