Huang Nai-Chih, Chang Hao-Hueng, Lin Chun-Pin
Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei City, Taiwan.
Department of Oral and Maxillofacial Surgery, National Taiwan University Hospital, Taipei, Taiwan.
J Dent Sci. 2025 Apr;20(2):1139-1147. doi: 10.1016/j.jds.2025.01.018. Epub 2025 Jan 30.
BACKGROUND/PURPOSE: Articaine is a dental anesthetic that has been developed and widely used in recent years. This study aimed to compare the anesthetic efficacy and safety of infiltration anesthesia with 4 % Articaine (with 1:100,000 epinephrine) and block anesthesia with 2 % Lidocaine (with 1:100,000 epinephrine) in the mandibular third molar extraction.
This prospective, randomized, split-mouth clinical trial was planned to involve 30 adults with the bilateral mandibular third molars. Participants were randomly assigned to receive 4 % Articaine (Articaine group) by infiltration anesthesia on one side and 2 % Lidocaine (Lidocaine group) by block anesthesia on the opposite side. Parameters such as the heart rate, blood pressure, oxygen saturation, anesthetic usage, operation duration, pain score, satisfaction, and adverse events were recorded and analyzed.
Finally, 26 participants receiving the bilateral mandibular third molar extraction were included. There were no significant differences in the heart rate, blood pressure, oxygen saturation, and maximum fluctuations during the extraction procedure between the two groups, except the maximum heart rate fluctuation showing statistical significance. Additionally, the amount of anesthetic used was significantly lower in the Articaine group (1.5 ± 0.4 cartridges) than in the Lidocaine group (2.2 ± 0.5 cartridges) ( < 0.001). There were no significant differences in the operation duration, pain score, and satisfaction between the two groups, and no adverse events were reported in either group.
Using 4 % Articaine for infiltration anesthesia offers comparable pain control to 2 % Lidocaine for block anesthesia in the mandibular third molar extraction surgery. Using 4 % Articaine can safely achieve similar pain control with lower doses and less invasive anesthesia techniques.
背景/目的：阿替卡因是近年来研发并广泛应用的一种牙科麻醉剂。本研究旨在比较4%阿替卡因（含1:100,000肾上腺素）浸润麻醉与2%利多卡因（含1:100,000肾上腺素）阻滞麻醉在下颌第三磨牙拔除术中的麻醉效果及安全性。
本前瞻性、随机、双侧对照临床试验计划纳入30例双侧下颌第三磨牙的成年患者。参与者被随机分配，一侧接受4%阿替卡因浸润麻醉（阿替卡因组），另一侧接受2%利多卡因阻滞麻醉（利多卡因组）。记录并分析心率、血压、血氧饱和度、麻醉剂用量、手术时长、疼痛评分、满意度及不良事件等参数。
最终纳入26例接受双侧下颌第三磨牙拔除术的参与者。两组在拔牙过程中的心率、血压、血氧饱和度及最大波动方面，除最大心率波动有统计学意义外，无显著差异。此外，阿替卡因组的麻醉剂用量（1.5±0.4支）显著低于利多卡因组（2.2±0.5支）（P<0.001）。两组在手术时长、疼痛评分及满意度方面无显著差异，且两组均未报告不良事件。
在下颌第三磨牙拔除手术中，4%阿替卡因浸润麻醉与2%利多卡因阻滞麻醉的镇痛效果相当。使用4%阿替卡因可通过更低剂量和侵入性更小的麻醉技术安全地实现类似的镇痛效果。
