Onset and duration of ۲% lidocaine as inferior alveolar nerve block versus buccal/lingual infiltration of ۴% articaine in mandibular second molars: Clinical trial study

BACKGROUND AND AIM: The effectiveness of buccal or lingual (B/L) infiltration of ۴% 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 ۲% lidocaine as inferior alveolar nerve block (IANB) versus B/L infiltration of ۴% articaine for pulp anesthesia, as primary injection in mandibular second molars.METHODS: Thirty adult volunteers ranging from ۱۸ to ۴۰ 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 ۲% lidocaine and ۱/۸۰۰۰۰ epinephrine using direct technique) and B/L infiltration group using ۴% articaine (Septanest; Septodont, Saint-Maur-des-Fosses, France). After obtaining base line sensitivity, electric pulp testing (EPT) was done at ۵, ۸, ۱۱, ۱۵, ۲۰, ۲۵, ۳۰, ۴۵, ۶۰, ۷۵, and ۹۰ minutes post injections. The data were analyzed using chi-square test.RESULTS: The success rate of anesthesia for IANB group was ۸۳.۳% (۲۵ of ۳۰ subjects) and ۳۰% (۹ of ۳۰ subjects) for B/L infiltration group, and the difference between the groups was statistically significant (P = ۰.۰۰۰۵). The mean onset time of pulp anesthesia for IANB group was ۲۲.۶ ± ۳۰.۹ minutes and ۶۵.۵ ± ۳۸.۰ for B/L infiltration group, and the difference between the groups was statistically significant (P = ۰.۰۰۰۱). The mean duration time of pulp anesthesia for IANB group was ۵۳.۰ ± ۲۷.۴ minutes and ۱۰.۶ ± ۱۷.۲ for B/L infiltration group, and the difference between the groups was statistically significant (P = ۰.۰۰۰۱).CONCLUSION: The results indicated that IANB using ۲% lidocaine was more successful than B/L infiltration of ۴% 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