Efficacy and safety of infiltration anesthesia with 4 % Articaine and block anesthesia with 2 % Lidocaine in the mandibular third molar extraction.

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.