Anesthetic Efficacy of Four Percent Articaine for Pulpal Anesthesia by Using Inferior Alveolar Nerve Block and Buccal Infiltration Techniques in Patients with Irreversible Pulpitis: A Prospective Randomized Double-blind Clinical Trial

Introduction: The study was designed as a randomized double-blind trial to evaluate the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine in inferior alveolar nerve block (IANB) and infiltration anesthetic techniques to anesthetize mandibular molars with irreversible pulpitis. Methods: The study was composed of 2 test arms and 1 control arm. Subjects in the test arms received either a standard IANB or a buccal infiltration (B Infil) of 4% articaine with 1:100,000 epinephrine, whereas the subjects in the control arm received a standard IANB of 2% lidocaine with 1:100,000 epinephrine. Subject's self-reported pain response was recorded on Heft Parker Visual Analogue Scale after. local anesthetic administration during access preparation and pulp extirpation. Results: For statistical analysis Pearson chi(2), Student's paired t test, 1-way analysis of variance, and Friedman tests showed no significant difference in success rates among the 3 arms of the trial. Conclusions: Although B Infil and IANB of 4% articaine were equally effective, B Infil can be considered a viable alterative in IANB for pulpal anesthesia in mandibular molars with irreversible pulpitis. (J Endod 2011;37:1603-1607)