Comparative Evaluation of Anesthetic Efficacy of 4% Articaine and 2% Lidocaine for Buccal Infiltration in Adult Patients with Irreversible Pulpitis of Maxillary First Molar: A Prospective Randomized Study

OBJECTIVE: The purpose of this prospective, randomized study was to evaluate and compare the anesthetic efficacy of 0.8 ml of 4% articaine and 1.6 ml of 2% lidocaine administered through buccal infiltration (submucosal) only in adult male and female patients with irreversible pulpitis of maxillary 1(st) molar. STUDY DESIGN: Two hundred patients with irreversible pulpitis of the maxillary first molar were divided into four study groups and received only buccal infiltration of either 0.8 ml of 4% articaine or 1.6 ml of 2% lidocaine. Endodontic access was begun 7 min after the solution deposition. The success was defined as “no pain (0 mm)” or “weak/mild pain (>0 mm and ≤54 mm)” during access opening, and during the first file insertion till working length. RESULTS: The compiled data of the number of failed cases were analyzed by two sample proportion test and of mean pain scores were analyzed by Student's unpaired t-test. P < 0.05 was taken as statistically significant. No significant difference was found in the number of failed cases on using 4% articaine and 2% lidocaine (P > 0.05). Moreover, no significant difference was found in the number of failed cases between the genders in Group I (4% articaine with 1:100,000 epinephrine) and also in Group II (2% lidocaine with 1:80,000 epinephrine). On comparing the mean pain scores of failed cases, it has been found that females experience more pain than males in Group I (not significant) and Group II (significant). CONCLUSION: The efficacy of 4% articaine with 1:100,000 epinephrine has been found to be better than 2% lidocaine with 1:80,000 epinephrine, as only 0.8 ml of 4% articaine with 1:100,000 epinephrine was effectively used as compared to 1.6 ml of 2% lidocaine with 1:80,000 epinephrine. Furthermore, females experience more pain as compared to males.