Anesthetic efficacy of Articaine Buccal Infiltration compared to Lidocaine Inferior Alveolar Nerve Block in symptomatic mandibular premolars: a randomized control trial

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Introduction: Pain during root canal treatment is the leading cause of anxiety among dental patients; 10-81% of patients with an irreversibly inflamed pulp experienced moderate pain during the procedure even after local anesthesia. Objective: To compare the anesthetic efficacy of 4% Articaine Buccal Infiltration to 2% Lidocaine Inferior Alveolar Nerve Block in patients with symptomatic irreversible pulpitis in mandibular premolars. Materials & Methods: A randomized control trial was done at the Endodontics Department of Rehman College of Dentistry, Peshawar, from January 2023 to July 2023. Eighty-six patients with symptoms of irreversible pulpitis in mandibular premolars were selected using purposive sampling technique and divided into two groups by random allocation using the lottery method: Articaine Buccal Infiltration and Lidocaine Inferior Alveolar Nerve Block. Pain was recorded at two points using Visual Analogue Scale (VAS): before the administration of anesthesia and during the root canal treatment. SPSS version 26.0 was used to enter and analyze the data for descriptive and comparative statistics. Differences of means were compared by the Paired Samples T test and the Independent Samples T test within and between the two groups. The Chi-square test was used to determine the anesthetic efficacy. A p value ≤0.05 was considered significant. Results: Four percent Articaine buccal infiltration was successful in 53.5% of the cases and 2% Lidocaine inferior alveolar nerve block was successful in 60.5% of the cases in anesthetizing mandibular premolars with signs of irreversible pulpitis. No significant difference was found between the two techniques (p>0.05). Conclusion: None of the two techniques showed superiority or produced profound anesthesia in irreversibly inflamed mandibular premolars. Supplemental anesthesia was needed for painless root canal treatment.

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