Comparison of the efficacy of articaine 4% and lidocaine 2% local anesthesia in the maxillary second primary molar in need of pulp therapy

Abstract

It has been shown that the fear of pain is a substantial deterrent for patients to seek dental care. To obviate this discouragement, employment of an efficacious method of pain control is necessary. Local anesthetics play a pivotal role to achieve this goal. With extra ester and thiophene groups that facilitate liposolubility of articaine in comparison with older counterparts such as lidocaine, it has been though that this local anesthetic is more efficacious in reducing pain during dental procedures. The available data, however, are heterogeneous. This study sought to compare the efficacy of articaine and lidocaine in controlling pain during pediatric dental manipulation. Materials and methods: In this double-blind, randomized clinical-trial, 56 children in need of pulp therapy(aged 6-9 years) received either 4 percent articaine with 1:100,000 epinephrine (n=28), or 2 percent lidocaine with epinephrine 1:80,000 (n=28) in the maxillary second primary molar. Number of patients with pain during dental procedure was compared between the two groups. Results: While 6 patients (21.4%) in articaine group complained from pain during dental procedure, this rate was 32.1% (9 patients) in lidocaine group. The difference, however, did not reach a statistically significant level (p=0.37, odds ratio: 0.66 with 95% confidence interval: 0.27-1.62). No significant complications were observed. Discussion: Although not statistically significant, articaine was more efficacious than lidocaine in controlling pain during dental procedure children in need of pulp therapy.