Chakraborty Suchismita, Pakyntein Mayakiru, Kataki Rubi, Deka Adrija, Roy Debosmita, Borah Diganta
Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, IND.
Cureus. 2025 Jul 30;17(7):e89090. doi: 10.7759/cureus.89090. eCollection 2025 Jul.
Achieving effective anesthesia during root canal treatment is particularly challenging in cases of symptomatic irreversible pulpitis due to the inflamed pulpal environment, which compromises anesthetic efficacy. Articaine and lignocaine are commonly used local anesthetics in endodontics, differing in onset time, duration, and pain control. The objective of this study was to compare the anesthetic efficacy of 2% lignocaine combined with 1:80,000 epinephrine with 4% articaine combined with 1:100,000 epinephrine during root canal treatment of permanent mandibular first molars in patients with symptomatic irreversible pulpitis.
100 patients, 18-30 years old, with symptomatic irreversible pulpitis in permanent mandibular first molars without any periapical pathology reported to the Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati. Following the provision of written informed consent, participants were randomly assigned to receive a conventional inferior alveolar nerve block using either 1.8 mL of 2% lignocaine with 1:80,000 epinephrine (n = 50) or 1.7 mL of 4% articaine with 1:100,000 epinephrine (n=50). Randomization was performed by an individual who did not take part in data acquisition. To avoid identification, the independent observer covered 50 cartridges containing 2% lignocaine and 50 cartridges containing 4% articaine with blue and pink colored tapes, respectively. Patients were subjectively assessed for lip anesthesia. Absence/presence of pulpal anesthesia was tested by using electric pulp stimulation, and absence/presence of pain was assessed by using a Short-Form McGill Pain Questionnaire (Appendix). Data were analyzed using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp., with the Student's paired t-test to compare outcomes between the groups.
The articaine group showed a faster onset of anesthesia (4.3 min vs. 7.8 min), longer duration (120.8 ± 3 min vs. 64.9 ± 5.2 min), and better pain control during root canal treatment (mean pain score: 1.09 vs. 1.63) compared to the lignocaine group. These differences were statistically highly significant (p < 0.001).
Articaine demonstrated faster onset, longer duration, and better pain control than lignocaine, making it a preferred choice for inferior alveolar nerve block in permanent mandibular first molars with symptomatic irreversible pulpitis.
在症状性不可逆性牙髓炎病例中，由于牙髓环境发炎，会影响麻醉效果，因此在根管治疗期间实现有效的麻醉尤其具有挑战性。阿替卡因和利多卡因是牙髓病学中常用的局部麻醉剂，在起效时间、持续时间和疼痛控制方面存在差异。本研究的目的是比较2%利多卡因联合1:80,000肾上腺素与4%阿替卡因联合1:100,000肾上腺素在症状性不可逆性牙髓炎患者下颌第一恒磨牙根管治疗期间的麻醉效果。
100名年龄在18至30岁之间、下颌第一恒磨牙患有症状性不可逆性牙髓炎且无任何根尖周病变的患者被报告至古瓦哈蒂地区牙科学院保守牙科与牙髓病科。在提供书面知情同意书后，参与者被随机分配接受传统的下牙槽神经阻滞，其中一组使用1.8毫升2%利多卡因联合1:80,000肾上腺素（n = 50），另一组使用1.7毫升4%阿替卡因联合1:100,000肾上腺素（n = 50）。随机分组由未参与数据采集的人员进行。为避免识别，独立观察者分别用蓝色和粉色胶带覆盖50支装有2%利多卡因的药筒和50支装有4%阿替卡因的药筒。对患者进行唇部麻醉的主观评估。通过牙髓电刺激测试牙髓麻醉的有无，并使用简化麦吉尔疼痛问卷（附录）评估疼痛的有无。使用IBM公司2011年发布的IBM SPSS Statistics for Windows，版本20.0对数据进行分析。采用学生配对t检验比较两组的结果。
与利多卡因组相比，阿替卡因组在根管治疗期间显示出更快的麻醉起效时间（4.3分钟对7.8分钟）、更长的持续时间（120.8±3分钟对64.9±5.2分钟）以及更好的疼痛控制（平均疼痛评分：1.09对1.63）。这些差异具有高度统计学意义（p < 0.001）。
与利多卡因相比，阿替卡因显示出更快的起效速度、更长的持续时间和更好的疼痛控制，使其成为患有症状性不可逆性牙髓炎的下颌第一恒磨牙下牙槽神经阻滞的首选。
