Anesthetic efficacy of articaine and lidocaine in endodontic treatment of mandibular molars with symptomatic irreversible pulpitis

Tóm tắt

Achieving adequate anesthesia in mandibular molars with symptomatic irreversible pulpitis remains challenging. This study compared the anesthetic efficacy of two common clinical regimens, 4% articaine via buccal infiltration and 2% lidocaine via inferior alveolar nerve block. A controlled clinical study was conducted on 60 mandibular molars with symptomatic   and electric pulp test (EPT) responses were recorded. Pre-injection pain was comparable between groups (p = 0.528). Post-injection pain was significantly lower in the articaine group (30.8 ± 16.4 vs 38.4 ± 24.8, p = 0.040). The need for supplemental anesthesia was lower in the articaine group than in the lidocaine group (23.3% vs 46.7%, p = 0.046). Pain during instrumentation was also lower with articaine (p = 0.044), whereas no difference reported during access or obturation. The time to achieve a negative EPT response was shorter with articaine (8.6 ± 2.3 vs 10.1 ± 3.4 minutes, p = 0.048). The overall success rate was significantly higher in the articaine group (76.7% vs 53.3%, p = 0.048). To conclude, the articaine buccal infiltration regimen demonstrated superior anesthetic efficacy compared with the lidocaine via inferior alveolar nerve block regimen, particularly in reducing post-injection pain, shortening onset time, and decreasing the need for supplemental anesthesia.