“Is 4% articaine better than 2% lignocaine during bilateral impacted maxillary canine extraction- a split mouth randomised clinical trial”
Is 4% articaine better than 2% lignocaine ?
DOI:
https://doi.org/10.52977/ujmfs.2021.1.3.2Keywords:
Articaine, lignocaine HCL, Tooth Extraction.Abstract
Aims and Objective: To compare the efficacy of 4% articaine hydrochloride and 2% lignocaine hydrochloride in the impacted bilateral maxillary canine extraction.
Materials and Methods: In this split mouth randomised clinical trial study was carried out in 10 patients who underwent extraction of impacted maxillary canine. Every patients received 0.6ml – 1ml of 4% articaine at experimental side and control side 2% lignocaine HCl 0.8-1.5 ml buccal and palatal infiltration both. All the parameters, drug volume, duration of anesthesia, pain score was noted and statistically compared.
Results:
The mean administred volume of articaine group ranged from 0.8 ± 0.13 ml while in lignocaine group it ranged 1.53 ± 0.21 ml (buccal+ palatal administration). The mean drug volume used of lignocaine group was comparatively higher than articaine group. Duration of anesthesia depending on subjective lip numbness. In articaine group mean value was 60.08 ± 7.90 minutes while in lignocaine group it ranged from mean 48.21± 8.75. It was higher in articaine group. Pain scale (VAS) in articaine on buccal infiltration ranged from mean value of 0.9 ± 0.62 while in lignocaine group mean was 3.04± 1.00. Pain score was found higher in lignocaine group. On palatal infiltration in lignocaine group mean value ranged from 4.04±1.00, while in articaine group there was no need of palatal infiltration.
Conclusion: This study provided clear evidence that single buccal infiltrations of 4% articaine was better than 2% lignocaine in terms of drug volume, onset of ansthesia, duration of anesthesia, pain rating. Like other anesthetics, it is really safe and even more effectice. It surpasses the requirement of the additional palatal anesthesia.
References
Haase A, Reader A, Nusstein J, Beck M, Drum M. Comparing anesthetic efficacy of articaine versus lidocaine as a supplemental buccal infiltration of the mandibular first molar after an inferior alveolar nerve block. J Am Dent Assoc 2008;139: 1228–35.
doi: 10.14219/jada.archive.2008.0338.
Jaber A, Whitworth JM, Corbett IP, Al-Baqshi B, Kanaa MD, Meechan JG. The efficacy of infiltration anaesthesia for adult mandibular incisors: a randomised double-blind cross-over trial comparing articaine and lidocaine buccal and buccal plus lingual infiltrations. Br Dent J 2010;209:E16.
doi:10.1038/sj.bdj.2010.974
Robertson D, Nusstein J, Reader A, Beck M, McCartney M. The anesthetic efficacy of articaine in buccal infiltration of mandibular posterior teeth. J Am Dent Assoc 2007; 138:1104–12.
doi: 10.14219/jada.archive.2007.0324
Kanaa MD, Whitworth JM, Corbett IP, Meechan JG. Articaine and lidocaine mandibular buccal infiltration anesthesia: a prospective randomised double-blind crossover study. J Endod 2006;32:296–8.
doi: 10.1016/j.joen.2005.09.016
Evans G, Nusstein J, Drum M, Reader A, Beck M. A prospective, randomized, double-blind comparison of articaine and lidocaine for maxillary infiltrations. J Endod 2008;34:389–93.
doi: 10.1016/j.joen.2008.01.004
Badcock ME, Gordon I, McCullough MJ. A blinded randomized controlled trial comparing lignocaine and placebo administration to the palate for removal of maxillary third molars. Int J Oral Maxillofac Surg 2007; 36: 1177-82.
doi: 10.1016/j.ijom.2007.06.001
Malamed SF. Handbook of Local Anesthetisia. 6th ed. St. Louis, Missouri, Mosby. 2013, pp 58-221.
McArdle BF. Painless palatal anesthesia. J Am Dent Assoc 1997; 128(5):647.
doi: 10.14219/jada.archive.1997.0265
Harker T. What injection? Br Dent J 1997;182(2):50.
doi: 10.1038/sj.bdj.4809297
Schulze-Husmann M. Experimental evaluation of the new local anesthetic Ultracaine in dental practice. Doctoral dissertation, Bonn, Germany, University of Bonn, 1974.
doI:https://doi.org/10.1016/j.tripleo.2005.12.005
Clinicians guide to dental products and techniques. Septocaine. CRA Newsletter. June 2001.
P. Arrow. A comparison of articaine 4% and lignocaine 2% in block and infiltration analgesia in children. Aust Dent J 2012; 57: 325-33.
doi: 10.1111/j.1834-7819.2012.01699.x
Chopra R, Marwaha M, Bansal K, Mittal M. Evaluation of buccal infiltration with articaine and inferior alveolar nerve block with lignocaine for pulp therapy in mandibular primary molars. J Clin Pediatr Dent 2016; 40: 301-5.
doi: 10.17796/1053-4628-40.4.301
Robertson D, Nusstein J, Reader A, Beck M, McCartney M. The anesthetic efficacy of articaine in buccal infiltration of mandibular posterior teeth. J Am Dent Assoc 2007; 138:1104–12.
doi: 10.14219/jada.archive.2007.0324
Evans G, Nusstein J, Drum M, Reader A, Beck M. A prospective, randomized, double-blind comparison of articaine and lidocaine for maxillary infiltrations. J Endod 2008;34:389–93.
doi: 10.1016/j.joen.2008.01.004
Costa CG, Tortamano IP, Rocha RG, Francischone CE, Tortamano N. Onset and duration periods of articaine and lidocaine on maxillary infiltration. Quintessence Int 2005;36:197–201.
Uckan S, Dayangac E, Araz K. Is permanent maxillary tooth removal without palatal injection possible? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102: 733–5.
doi: 10.1016/j.tripleo.2005.12.005
Jaber A, Whitworth JM, Corbett IP, Al-Baqshi B, Kanaa MD, Meechan JG. The efficacy of infiltration anaesthesia for adult mandibular incisors: a randomised double-blind cross-over trial comparing articaine and lidocaine buccal and buccal plus lingual infiltrations. Br Dent J 2010;209:E16.
doi:10.1038/sj.bdj.2010.974
Vahatalo K, Antila H, Lehtinen R. Articaine and lidocaine for maxillary infiltration anesthesia. Anesth Prog 1993;40:114–6.
Oliveira PC, Volpato MC, Ramacciato JC, Ranali J. Articaine and lignocaine efficiency in infiltration anaesthesia: a pilot study. Br Dent J 2004;197:45–6.
doi: 10.1038/sj.bdj.4811422
Alcântara CE, Falci SG, Oliveira-Ferreira F, Santos CR, Pinheiro ML. Pre-emptive effect of dexamethasone and methylprednisolone on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind clinical trial. Int J Oral Maxillofac Surg. 2014 Jan;43(1):93-8.
doi: 10.1016/j.ijom.2013.05.016
Fan S, Chen WL, Yang ZH, Huang ZQ. Comparison of the efficiencies of permanent maxillary tooth removal performed with single buccal infiltration versus routine buccal and palatal injection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:359-363.
Doi:10.1016/j.tripleo.2008.08.025
Dattara ya A Darawade, Santosh Kumar,Santosh kumar,Shilpa Budhiraja et al A clinical study of efficacy of 4% artcaine Hydrochloride Versus 25 Lignocaine Hcl in dentistry J Int Oral Health. 2014 Sept-Oct;6(5):81-83
Shahid Hassan, B.H. Sripathi Raol, Joyce Sequerial et al efficacy of 45 Articaine HCL and 2% Lignocaine Hcl in the extraction of maxillary premolars for orthodontic reason .Annals of maxillofacial surgery;2011:1(1).
doi: 10.4103/2231-0746.83145