Efficacy of 4% articaine hydrochloride and 2% lignocaine hydrochloride in the extraction of maxillary premolars for orthodontic reasons

BACKGROUND: Articaine is an amide local anesthetic that differs from other agents of its group due to the presence of a thiophene ring instead of a benzene ring, and it is one of the commonly used local anesthetic agents for day care surgeries. Some researches claim that articaine is superior to lidocaine in its biologic profile. PURPOSE: To evaluate the efficacy, time of onset of anesthesia, duration of action and intra- or post-administration complications of articaine in comparison with lignocaine for bilateral extraction of maxillary premolars for orthodontic reasons. MATERIALS AND METHODS: The study was carried out in 20 patients visiting the Department of Oral and Maxillofacial Surgery, Yenepoya Dental College and Hospital, Mangalore, needing bilateral extraction of maxillary premolars for orthodontic purposes. A volume of 0.6–1 ml of 4% articaine hydrochloride (HCl) was injected in the buccal vestibule on one side and 1–2 ml of 2% lignocaine HCl was injected on the other side. After attaining adequate anesthesia, the extraction procedure was carried out under aseptic conditions. RESULTS: An onset period 0.975 ± 0.1118 and 2.950 ± 0.5104 min and duration of anesthesia of 72 ± 17.275 and 49 ± 5.026 min was found for articaine and lignocaine, respectively. Statistically significant differences were noted in the perception of pain using the visual analogue scale. CONCLUSION: Articaine can be used as an alternative to lignocaine, especially in the extraction of maxillary premolars for orthodontic reasons. The clinical advantages including rapid onset, longer duration of action and greater diffusing property over lignocaine and the elimination of the need for a painful palatal injection were demonstrated.