Share This Article:

Local anaesthesia using Articaine and Lidocaine in oral and dental surgery: A comparative meta-analysis

Abstract Full-Text HTML Download Download as PDF (Size:313KB) PP. 84-91
DOI: 10.4236/ojst.2014.42014    3,255 Downloads   5,254 Views   Citations

ABSTRACT

Background: Articaine is an amide local anaesthetic, which is gaining popularity for use in dental and oral surgical anaesthesia in the United Kingdom. Hitherto there has been insufficient evidence to recommend articaine above the more commonly used lidocaine for dental procedures. The aim of this study is to compare the efficacy of 4% articaine with 1:100,000 adrenaline (4AA) with that of 2% lidocaine with 1:100,000 adrenaline (2LA) administered as buccal infiltrations for anaesthesia in mandibular permanent first molar teeth. Any significant advantage noted may obviate the need for regional blockage of the inferior dental nerve in dental or minor oral surgical procedure under local anaesthesia. Objectives: To review the published literature comparing the efficacies of 4AA and 2LA for achieving pulpal anaesthesia in human mandibular permanent first molar teeth. Null Hypothesis: 4AA and 2LA are of equal efficacy when used to anaesthetize mandibular permanent first molar teeth by buccal infiltration. Method: An electronic search encompassing Ovid MEDLINE?, PubMed (National Center for Biotechnology Information, US National Library of Medicine), SCOPUS?, SCIRUS?, EMBASE? databases and the Cochrane Library was performed to identify trials relating to the efficacy of 4AA and 2LA local anaesthetic solutions on mandibular first molars in adult participants. Study characteristics and outcome data were extracted as a basis for meta-analysis. Results: Three randomised controlled trials were identified for this meta-analysis. The relative efficacy of 4AA over 2LA in anesthetizing permanent first mandibular molars was calculated at 1.57 (95% CI = 1.27 to 1.95). Conclusion: Despite the promising results shown in the meta-analysis it is difficult to say from the evidence presented that 4AA should be used clinically in preference over 2LA.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Saggu, M. , Aga, H. , Saggu, J. and Burke, G. (2014) Local anaesthesia using Articaine and Lidocaine in oral and dental surgery: A comparative meta-analysis. Open Journal of Stomatology, 4, 84-91. doi: 10.4236/ojst.2014.42014.

References

[1] Moore, P.A., Nahouraii, H.S., Zovko, J.G. and Wisniewski, S.R. (2006) Dental therapeutic practice patterns in the U.S. I. Anesthesia and sedation. General Dentistry, 54, 92-98.
[2] Yagiela, J.A. (2004) Recent developments in local anesthesia and oral sedation. Compendium of Continuing Education in Dentistry, 25, 697-706.
[3] Malamed, S.F., Gagnon, S. and Leblanc, D. (2001) Articaine hydrochloride: A study of the safety of a new amide local anesthetic. The Journal of the American Dental Association, 132, 177-185.
http://dx.doi.org/10.14219/jada.archive.2001.0152
[4] Corbett, I.P., Kanaa, M.D., Whitworth, J.M. and Meechan, J.G. (2008) Articaine infiltration for anesthesia of mandibular first molars. Journal of Endodontics, 34, 514-518.
http://dx.doi.org/10.1016/j.joen.2008.02.042
[5] Moher, D., Liberati, A., Tetzlaff, J. and Altman, D.G. (2009) Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine, 151, 264-269.
http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00135
[6] Schulz, K.F., Altman, D.G. and Moher, D. (2010) CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. British Medical Journal, 340, 332.
http://dx.doi.org/10.1136/bmj.c332
[7] Abdulwahab, M., Boynes, S., Moore, P., Seifikar, S., Al-Jazzaf, A., Alshuraidah, A., Zovko, J. and Close, J. (2009) The efficacy of six local anesthetic formulations used for posterior mandibular buccal infiltration anesthesia. Journal of the American Dental Association, 140, 1018-1024.
http://dx.doi.org/10.14219/jada.archive.2009.0313
[8] Robertson, D., Nusstein, J., Reader, A., Beck, M. and McCartney, M. (2007) The anesthetic efficacy of articaine in buccal infiltration of mandibular posterior teeth. Journal of the American Dental Association, 138, 1104-1112.
http://dx.doi.org/10.14219/jada.archive.2007.0324
[9] Kanaa, M.D., Whitworth, J.M., Corbett, I.P. and Meechan, J.G. (2006) Articaine and lidocaine mandibular buccal infiltration anesthesia: A prospective randomized double-blind cross-over study. Journal of Endodontics, 32, 296.
http://dx.doi.org/10.1016/j.joen.2005.09.016
[10] Skjevik, ?.A., Haug, B.E., Lygre, H. and Teigen, K. (2011) Intramolecular hydrogen bonding in articaine can be related to superior bone tissue penetration: A molecular dynamics study. Biophysical Chemistry, 154, 18-25.
http://dx.doi.org/10.1016/j.bpc.2010.12.002
[11] Jaber, A., Whitworth, J.M., Corbett, I.P., Al-Baqshi, B., Kanaa, M.D. and Meechan, J.G. (2010) 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. British Dental Journal, 209, e16.
http://dx.doi.org/10.1038/sj.bdj.2010.974
[12] Oliveira, P.C., Volpato, M.C., Ramacciato, J.C. and Ranali, J. (2004) Articaine and lignocaine efficiency in infiltration anaesthesia: A pilot study. British Dental Journal, 197, 45-46.
http://dx.doi.org/10.1038/sj.bdj.4811422
[13] Kammerer, P.W., Palarie, V., Daublander, M., Bicer, C., Shabazfar, N., Brullmann, D. and Al-Nawas, B. (2012) Comparison of 4% articaine with epinephrine (1:100,000) and without epinephrine in inferior alveolar block for tooth extraction: Double-blind randomized clinical trial of anesthetic efficacy. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 113, 495-499.
http://dx.doi.org/10.1016/j.tripleo.2011.04.037
[14] Jung, I.Y., Kim, J.H., Kim, E.S., Lee, C.Y. and Lee, S.J. (2008) An evaluation of buccal infiltrations and inferior alveolar nerve blocks in pulpal anesthesia for mandibular first molars. Journal of Endodontics, 34, 11-13.
http://dx.doi.org/10.1016/j.joen.2007.09.006
[15] National Patient Safety Agency (2004) Managing patients who are taking warfarin and undergoing dental treatment.
http://www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID=60028&
[16] Katyal, V. (2010) The efficacy and safety of articaine versus lignocaine in dental treatments: A meta-analysis. Journal of Dentistry, 38, 307.
http://dx.doi.org/10.1016/j.jdent.2009.12.003

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.