The Efficacy of 4% Articaine Infiltration Anesthesia in the Extraction of Mandibular Molars: A Randomized Controlled Study
Introduction: Articaine was developed in 1969, with reported advantages which are increased potency, increased duration of its anesthetic effect and superior diffusion through bony tissue. The effectiveness of using 4% articaine infiltration for extraction of mandibular molar teeth in comparison to 2% lidocaine inferior alveolar nerve block is not settled yet.
Aim: The aim of this study was to evaluate the effectiveness of using 4% articaine infiltration for extraction of mandibular molars by comparing it to the use of 2% lidocaine inferior alveolar nerve block in terms of success, the volume of local anesthetic agents and the pain experienced during the procedure.
Materials and methods: A prospective randomized controlled study included 210 patients indicated for extraction of unrestorable mandibular molars, they were randomly assigned into 2 groups; a control group in which the extraction was carried out under inferior alveolar nerve block with 1.8 ml 2% lidocaine with 1:80,000 epinephrine and a study group in which the extraction proceeded under infiltration with 1.8 ml articaine with 1:100,000 epinephrine. The variables investigated included; the success and failure of extraction, the volume of local anesthetic required completing the extraction 1.8 or 3.2 ml and the degree of pain experienced during extraction assessed by pain numerical rating scale.
Results and discussion: Both groups showed a statistically non-significant difference in providing local anesthesia although the control group had a higher success rate. With respect to the volume of anesthesia required to complete the extraction the study group required 3.6 ml anesthesia more often than the control group with a statistically significant difference, also the study group demonstrated statistically higher scores of pain than the control group.
Conclusion: 4% Articaine infiltration demonstrated fewer efficacies than 2% lidocaine inferior alveolar nerve block in the extraction of mandibular molars.