Anesthetic Efficacy of Articaine and Lidocaine in Lower Molars With Irreversible Pulpits

University of Campinas, Brazil

Status and phase: Completed; Phase 4

Conditions: Irreversible Pulpitis; Pain

Treatments: Drug: 4% articaine with 1:100,000 epinephrine; Drug: 2% lidocaine with 1:100,000 epinephrine

Study type: Interventional

Funder types: Other

Identifiers

NCT01912755

2009-10834-4

Details and patient eligibility

About

The aim of this study was to verify the effectiveness of an anesthetic called articaine for dental treatment, comparing it with an anesthetic commonly used in dental clinic: lidocaine. Two types of local anesthesia (oral injection) in accordance with the solution used were performed. For patients anesthetized with articaine, an injection of anesthesia close to the tooth to be treated was used. For the anesthetic lidocaine an injection on the cheek at the bottom of the mouth was made. Differences between both techniques are mainly regarding the area of numbness. In the injection with articaine only a small part of the lip and the tooth was anesthetized. With lidocaine injection, the lower region of the entire side of the tooth and half of the tongue on the same side was numbed. The treatment was electronic randomized and there was equal chance to one or another treatment. The investigators are studying this new form of anesthesia (near the tooth that was treated) to see if it can numb the tooth to an emergency treatment, if it really decreases the feeling of numbness and discomfort during the service. Patients receiving articaine were submitted to cone beam exam at no cost.

Full description

Aim: This randomized clinical trial compared the anesthetic efficacy of buccal infiltration (BI) with 4% articaine (AR) and inferior alveolar nerve block (IANB) with 2% lidocaine (LI), both with 1:100,000 epinephrine, in symptomatic mandibular molars with irreversible pulpitis. Likewise, we compared the efficacy of the primary infiltration (BI or IANB) with one supplemental injection (intraligamentary infiltration with articaine for AR and BI with articaine for LI). The influences of buccal cortical bone thickness and root distances to buccal cortical bone on articaine performance (AR) were also evaluated using cone-beam tomography. methodology: Volunteers presenting symptomatic mandibular molars with irreversible pulpitis were randomly divided into two groups (30 for AR and 20 for LI). Success was recorded when complete pain-free treatment was achieved after primary injection or when one supplemental injection was needed for emergency endodontic procedures.

Enrollment: 50 patients

Sex: All

Ages: 18 to 50 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• long-lasting moderate to severe pain during cold test
• absence of periapical radiolucency except for a widened periodontal ligament (evaluated in periapical radiographs)
• vital coronal pulp on access opening

Exclusion criteria

• Previous history of allergy to local anesthetics
• Subjects with systemic diseases
• Pregnancy and lactation
• Subjects taking any kind of medication that could change or influence the outcome of this research
• Subjects without painful symptoms
• Negative thermal testing, periapical lesion, incomplete root formation, presence of fistula or abscess, cracks or fractures

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

50 participants in 2 patient groups

Articaine

Experimental group

Description:

injection of 1.8 mL buccal infiltrations of 4% articaine with 1:100,000 epinephrine in one tooth with a clinical diagnosis of symptomatic irreversible pulpitis.

Treatment:

Drug: 2% lidocaine with 1:100,000 epinephrine

Drug: 4% articaine with 1:100,000 epinephrine

Lidocaine

Active Comparator group

Description:

1.8 mL 2% lidocaine with 1:100,000 epinephrine injected as inferior alveolar nerve block in the mandible side with one tooth with a clinical diagnosis of symptomatic irreversible pulpitis.

Treatment:

Drug: 2% lidocaine with 1:100,000 epinephrine

Drug: 4% articaine with 1:100,000 epinephrine