Volume 7, Issue 3 (Journal of Research in Dental & Maxillofacial Sciences Summer 2022)                   J Res Dent Maxillofac Sci 2022, 7(3): 119-124 | Back to browse issues page

Ethics code: IR.IAU.DENTAL.REC.1395,18
Clinical trials code: IRCT2017020223620N6


XML Print


1- Department of Endodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
2- Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
3- Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran , porazavi1@yahoo.com
Abstract:   (210 Views)
Background and Aim: Achieving adequate pulpal anesthesia could be challenging in mandibular molars. There are some disagreements about the success rate of local infiltration anesthesia with articaine as primary injection. Therefore, the aim of this study was to assess the efficacy of 4% articaine lingual subperiosteal injection as the primary injection for permanent mandibular second molars in comparison with inferior alveolar nerve block (IANB).  
Materials and Methods: Fifteen healthy adult volunteers participated in this study. A randomized, split-mouth, single-blind design was used to allocate each side of the mandible in each patient to the test or control group. On the test side, lingual subperiosteal injection with 4% articaine and 1:100,000 epinephrine was
performed for the mandibular second molar; whereas, in the control group, an IANB with 2% lidocaine and 1:80,000 epinephrine was administered. Electric pulp testing was done at baseline, and also at 5, 8, 11, 15, 20, 25, 30, 45, 60, 75, and 90 minutes after injection. Statistical analysis was carried out using t-test and Chi-square test.

Results: The success rate of IANB was significantly higher than that of lingual subperiosteal injection (P=0.0001). The difference in the onset of action between the two groups was significant (P<0.05). Anesthesia duration was 61.0±28.0 minutes in IANB group and 10.2±12.4 minutes in lingual subperiosteal injection group, with a significant difference between them (P<0.01).
Conclusion: IANB with 2% lidocaine is preferable to 4% articaine lingual subperiosteal injection due to its superior success rate, faster onset of action, and longer duration of effect.

Full-Text [PDF 744 kb]   (135 Downloads) |   |   Full-Text (HTML)  (66 Views)  

References
1. Ogle OE, Mahjoubi G. Local anesthesia: agents, techniques, and complications. Dent Clin North Am. 2012 Jan;56(1):133-48, ix. [DOI:10.1016/j.cden.2011.08.003] [PMID]
2. Joshi A, Soni HK. Efficacy of Infiltration Anaesthesia of 4% Articaine HCl (buccal) Versus 2% Lignocaine HCl (buccolingual) in Extraction of Mandibular Premolars: A Single Centred, Randomised, Crossover Group Study. J Maxillofac Oral Surg. 2020 Sep;19(3):431-7. [DOI:10.1007/s12663-019-01297-8] [PMID] [PMCID]
3. Jamil FA, Asmael HM, Al-Jarsha MY. The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study. BMC Oral Health. 2020 Aug 31;20(1):239. [DOI:10.1186/s12903-020-01228-x] [PMID] [PMCID]
4. Rayati F, Noruziha A, Jabbarian R. Efficacy of buccal infiltration anaesthesia with articaine for extraction of mandibular molars: a clinical trial. Br J Oral Maxillofac Surg. 2018 Sep;56(7):607-10. [DOI:10.1016/j.bjoms.2018.06.012] [PMID]
5. Figueiredo R, Sofos S, Soriano-Pons E, Camps-Font O, Sanmarti-García G, Gay-Escoda C, Valmaseda-Castellón E. Is it possible to extract lower third molars with infiltration anaesthesia techniques using articaine? A double-blind randomized clinical trial. Acta Odontol Scand. 2021 Jan;79(1):1-8. [DOI:10.1080/00016357.2020.1760348] [PMID]
6. Renton T, Adey-Viscuso D, Meechan JG, Yilmaz Z. Trigeminal nerve injuries in relation to the local anaesthesia in mandibular injections. Br Dent J. 2010 Nov;209(9):E15. [DOI:10.1038/sj.bdj.2010.978] [PMID]
7. El-Kholey KE. Anesthetic Efficacy of 4 % Articaine During Extraction of the Mandibular Posterior Teeth by Using Inferior Alveolar Nerve Block and Buccal Infiltration Techniques. J Maxillofac Oral Surg. 2017 Mar;16(1):90-5. [DOI:10.1007/s12663-015-0877-z] [PMID] [PMCID]
8. Majid OW, Muhammad ZA. Effectiveness of Articaine Buccal Infiltration Anesthesia for Mandibular Premolar Extraction: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. J Oral Maxillofac Surg. 2019 Sep;77(9):1784-9. [DOI:10.1016/j.joms.2019.03.033] [PMID]
9. Zain M, Rehman Khattak SU, Sikandar H, Shah SA, Fayyaz. Comparison of Anaesthetic Efficacy of 4% Articaine Primary Buccal Infiltration Versus 2% Lidocaine Inferior Alveolar Nerve Block in Symptomatic Mandibular First Molar Teeth. J Coll Physicians Surg Pak. 2016 Jan;26(1):4-8.
10. Robertson D, Nusstein J, Reader A, Beck M, McCartney M. The anesthetic efficacy of articaine in buccal infiltration of mandibular posterior teeth. J Am Dent Assoc. 2007 Aug;138(8):1104-12. [DOI:10.14219/jada.archive.2007.0324] [PMID]
11. Foster W, Drum M, Reader A, Beck M. Anesthetic efficacy of buccal and lingual infiltrations of lidocaine following an inferior alveolar nerve block in mandibular posterior teeth. Anesth Prog. 2007 Winter;54(4):163-9. [DOI:10.2344/0003-3006(2007)54[163:AEOBAL]2.0.CO;2]
12. Venkat Narayanan J, Gurram P, Krishnan R, Muthusubramanian V, Sadesh Kannan V. Infiltrative local anesthesia with articaine is equally as effective as inferior alveolar nerve block with lidocaine for the removal of erupted molars. Oral Maxillofac Surg. 2017 Sep;21(3):295-9. [DOI:10.1007/s10006-017-0628-z] [PMID]
13. Esnaashari E, Bakhtiar H, Nazari B, Mirzaei S, Tour-Savadkouhi S. Onset and duration of 2% lidocaine as inferior alveolar nerve block versus buccal/lingual infiltration of 4% articaine in mandibular second molars: Clinical trial study. Journal of Oral Health and Oral Epidemiology. 2018;7(3):113-7.
14. Bataineh AB, Alwarafi MA. Patient's pain perception during mandibular molar extraction with articaine: a comparison study between infiltration and inferior alveolar nerve block. Clin Oral Investig. 2016 Nov;20(8):2241-50. [DOI:10.1007/s00784-016-1712-8] [PMID]
15. Briggs M, Closs JS. A descriptive study of the use of visual analogue scales and verbal rating scales for the assessment of postoperative pain in orthopedic patients. J Pain Symptom Manage. 1999 Dec;18(6):438-46. [DOI:10.1016/S0885-3924(99)00092-5]
16. Jung IY, Kim JH, Kim ES, Lee CY, Lee SJ. An evaluation of buccal infiltrations and inferior alveolar nerve blocks in pulpal anesthesia for mandibular first molars. J Endod. 2008 Jan;34(1):11-3. [DOI:10.1016/j.joen.2007.09.006] [PMID]
17. Kanaa MD, Whitworth JM, Corbett IP, Meechan JG. Articaine and lidocaine mandibular buccal infiltration anesthesia: a prospective randomized double-blind cross-over study. J Endod. 2006 Apr;32(4):296-8. [DOI:10.1016/j.joen.2005.09.016] [PMID]
18. Certosimo AJ, Archer RD. A clinical evaluation of the electric pulp tester as an indicator of local anesthesia. Oper Dent. 1996 Jan-Feb;21(1):25-30.
19. McDaniel KF, Rowe NH, Charbeneau GT. Tissue response to an electric pulp tester. J Prosthet Dent. 1973 Jan;29(1):84-7. [DOI:10.1016/0022-3913(73)90144-3]
20. Dreven LJ, Reader A, Beck M, Meyers WJ, Weaver J. An evaluation of an electric pulp tester as a measure of analgesia in human vital teeth. J Endod. 1987 May;13(5):233-8. [DOI:10.1016/S0099-2399(87)80097-3]
21. Monteiro MR, Groppo FC, Haiter-Neto F, Volpato MC, Almeida JF. 4% articaine buccal infiltration versus 2% lidocaine inferior alveolar nerve block for emergency root canal treatment in mandibular molars with irreversible pulpits: a randomized clinical study. Int Endod J. 2015 Feb;48(2):145-52. [DOI:10.1111/iej.12293] [PMID]
22. Reisman D, Reader A, Nist R, Beck M, Weaver J. Anesthetic efficacy of the supplemental intraosseous injection of 3% mepivacaine in irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Dec;84(6):676-82. [DOI:10.1016/S1079-2104(97)90372-3]
23. Tortamano IP, Siviero M, Costa CG, Buscariolo IA, Armonia PL. A comparison of the anesthetic efficacy of articaine and lidocaine in patients with irreversible pulpitis. J Endod. 2009 Feb;35(2):165-8. [DOI:10.1016/j.joen.2008.10.020] [PMID]

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.