Content area
Full text
Abstract Articaine is fast becoming the anesthesia of choice for many endodontists across the globe. Before it completely replaces the" gold standard" lidocaine its anesthetic efficacy for dental use must be determined accurately. The objective of this study was to compare the anesthetic efficacy of articaine with lidocaine for buccal infiltration in patients with acute irreversible pulpitis. Seventy-six patients with acute irreversible pulpitis of maxillary first premolar were randomly selected. Patients receiving 1.7 ml of 2% lidocaine with 1:100000 epinephrine injection (group 1) and those receiving 1.7 ml of 4% articaine wtih 1:1000000 (group 2) were asked to rate their pain level on visual analogue scale (VAS) before receiving the anesthesia. Success was defined as mild or no pain on endodontic access or initial instrumentation based on the readings of visual analogue scale.
Statistically no significant difference in the anesthetic efficacy of articaine and lidocaine as buccal infiltration agents was found. Hence articaine hydrochloride has comparable anesthetic efficacy to that of lidocaine.
Key Words: Irreversible pulpitis buccal infiltration pulpal anesthesia Visual analogue scale Articaine Lidocaine.
INTRODUCTION Profound local anesthesia is necessary for success ful patient management in endodontic therapy. Since the beginning of dentistry numerous compounds and methods have been tried and used to obtain anesthesia. Lidocaine hydrochloride became the first marketed amide local anesthetic and now it is considered the "Gold Standard" to which other anesthetic solutions are compared.1 In 1969 a newer anesthetic drug Articaine was introduced as carticaine. It contains a lipophilic thiophene ring than the usual benzene ring seen in other amide based local anesthetic solutions along with an additional ester ring. This unique property renders articaine better lipid soluble and increases its protein binding ability. Several studies have shown that 4% articaine has superior efficacy than 2% lignocaine as inferior blocking agent and mandibular buccal infiltration anesthesia.234 Same results were found in maxilla when buccal infiltration with lidocaine and articaine was compared.5 Most studies have been carried out on sound teeth. Very little data is available on maxillary teeth with irreversible pulpitis. One study by Srinivasan et al6 showed success rate of 100% with articaine and 80% with lidocaine when used for pulpal anesthesia of maxillary premolars and 100% and 30% in molars respectively. No research data is available...