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

Ehsan Esnaashari, Hengameh Bakhtiar, Bahareh Nazari, Shadi Mirzaei, Sohrab Tour-Savadkouhi

Abstract


BACKGROUND AND AIM: The effectiveness of buccal or lingual (B/L) infiltration of 4% articaine as supplemental injection for pulp anesthesia of mandibular teeth was confirmed in previous studies. However, this study was aimed to compare the effectiveness of 2% lidocaine as inferior alveolar nerve block (IANB) versus B/L infiltration of 4% articaine for pulp anesthesia, as primary injection in mandibular second molars.

METHODS: Thirty adult volunteers ranging from 18 to 40 years old with no systemic disease or medicine intake were included in this split-mouth, double-blind, randomized clinical trial study. Each mandibular side of included subjects was allocated randomly to control group (IANB using 2% lidocaine and 1/80000 epinephrine using direct technique) and B/L infiltration group using 4% articaine (Septanest; Septodont, Saint-Maur-des-Fosses, France). After obtaining base line sensitivity, electric pulp testing (EPT) was done at 5, 8, 11, 15, 20, 25, 30, 45, 60, 75, and 90 minutes post injections. The data were analyzed using chi-square test.

RESULTS: The success rate of anesthesia for IANB group was 83.3% (25 of 30 subjects) and 30% (9 of 30 subjects) for B/L infiltration group, and the difference between the groups was statistically significant (P = 0.0005). The mean onset time of pulp anesthesia for IANB group was 22.6 ± 30.9 minutes and 65.5 ± 38.0 for B/L infiltration group, and the difference between the groups was statistically significant (P = 0.0001). The mean duration time of pulp anesthesia for IANB group was 53.0 ± 27.4 minutes and 10.6 ± 17.2 for B/L infiltration group, and the difference between the groups was statistically significant (P = 0.0001).

CONCLUSION: The results indicated that IANB using 2% lidocaine was more successful than B/L infiltration of 4% articaine in onset and duration of pulp anesthesia of mandibular second molars as primary injections.


Keywords


Articaine; Lidocaine; Local Anesthesia; Molar; Inferior Alveolar Nerve; Volunteers

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References


Malamed SF, Gagnon S, Leblanc D. Articaine hydrochloride: A study of the safety of a new amide local anesthetic. J Am Dent Assoc 2001; 132(2): 177-85.

Goodman A, Reader A, Nusstein J, Beck M, Weaver J. Anesthetic efficacy of lidocaine/meperidine for inferior alveolar nerve blocks. Anesth Prog 2006; 53(4): 131-9.

Kanaa MD, Meechan JG, Corbett IP, Whitworth JM. Speed of injection influences efficacy of inferior alveolar nerve blocks: A double-blind randomized controlled trial in volunteers. J Endod 2006; 32(10): 919-23.

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; 34(1): 11-3.

Nusstein J, Claffey E, Reader A, Beck M, Weaver J. Anesthetic effectiveness of the supplemental intraligamentary injection, administered with a computer-controlled local anesthetic delivery system, in patients with irreversible pulpitis. J Endod 2005; 31(5): 354-8.

Bigby J, Reader A, Nusstein J, Beck M, Weaver J. Articaine for supplemental intraosseous anesthesia in patients with irreversible pulpitis. J Endod 2006; 32(11): 1044-7.

Stein P, Brueckner J, Milliner M. Sensory innervation of mandibular teeth by the nerve to the mylohyoid: Implications in local anesthesia. Clin Anat 2007; 20(6): 591-5.

Srinivasan N, Kavitha M, Loganathan CS, Padmini G. Comparison of anesthetic efficacy of 4% articaine and 2% lidocaine for maxillary buccal infiltration in patients with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107(1): 133-6.

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; 54(4): 163-9.

McEntire M, Nusstein J, Drum M, Reader A, Beck M. Anesthetic efficacy of 4% Articaine with 1:100,000 epinephrine versus 4% articaine with 1:200,000 epinephrine as a primary buccal infiltration in the mandibular first molar. J Endod 2011; 37(4): 450-4.

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; 138(8): 1104-12.

Corbett IP, Kanaa MD, Whitworth JM, Meechan JG. Articaine infiltration for anesthesia of mandibular first molars. J Endod 2008; 34(5): 514-8.

Aggarwal V, Singla M, Miglani S. Comparative evaluation of anesthetic efficacy of 2% lidocaine, 4% articaine, and 0.5% bupivacaine on inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: A prospective, randomized, double-blind clinical trial. J Oral Facial Pain Headache 2017; 31(2): 124-8.

Corbella S, Taschieri S, Mannocci F, Rosen E, Tsesis I, Del Fabbro M. Inferior alveolar nerve block for the treatment of teeth presenting with irreversible pulpitis: A systematic review of the literature and meta-analysis. Quintessence Int 2017; 48(1): 69-82.

Martin M, Nusstein J, Drum M, Reader A, Beck M. Anesthetic efficacy of 1.8 mL versus 3.6 mL of 4% articaine with 1:100,000 epinephrine as a primary buccal infiltration of the mandibular first molar. J Endod 2011; 37(5): 588-92.

da Silva-Junior GP, de Almeida Souza LM, Groppo FC. Comparison of Articaine and lidocaine for buccal infiltration after inferior alveolar nerve block for intraoperative pain control during impacted mandibular third molar surgery. Anesth Prog 2017; 64(2): 80-4.

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; 26(1): 4-8.

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; 32(4): 296-8.

Matthews R, Drum M, Reader A, Nusstein J, Beck M. Articaine for supplemental buccal mandibular infiltration anesthesia in patients with irreversible pulpitis when the inferior alveolar nerve block fails. J Endod 2009; 35(3): 343-6.

Aggarwal V, Singla M, Kabi D. Comparative evaluation of anesthetic efficacy of Gow-Gates mandibular conduction anesthesia, Vazirani-Akinosi technique, buccal-plus-lingual infiltrations, and conventional inferior alveolar nerve anesthesia in patients with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109(2): 303-8.

Parirokh M, Satvati SA, Sharifi R, Rekabi AR, Gorjestani H, Nakhaee N, et al. Efficacy of combining a buccal infiltration with an inferior alveolar nerve block for mandibular molars with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109(3): 468-73.

Piccinni C, Gissi DB, Gabusi A, Montebugnoli L, Poluzzi E. Paraesthesia after local anaesthetics: An analysis of reports to the FDA Adverse Event Reporting System. Basic Clin Pharmacol Toxicol 2015; 117(1): 52-6.

Kakroudi SH, Mehta S, Millar BJ. Articaine hydrochloride: Is it the solution? Dent Update 2015; 42(1): 88-3.




DOI: http://dx.doi.org/10.22122/johoe.v0i0.366

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