A comparison of articaine 4% and lignocaine 2% in block and infiltration analgesia in children

Abstract

BACKGROUND: Articaine administered through buccal infiltration (BI) has been suggested as providing adequate posterior mandibular analgesia. This study compared the efficacy of articaine 4% with 1:100 000 adrenaline (test) and lignocaine 2% with 1:80 000 adrenaline (control), delivered either through an inferior alveolar nerve block (IANB) or BI for routine restorative procedures in mandibular posterior teeth among children. METHODS: Children enrolled within the Western Australian School Dental Service and in need of restorative care on contralateral mandibular posterior teeth were eligible. Consenting children were randomly allocated to test and control techniques, and to type of local anaesthetic. Using the faces pain scale, pain reports from analgesia administration and from dental treatment were elicited. Analgesia success and pain reports were compared by anaesthetic technique and type. RESULTS: Fifty-seven children were recruited into the study; 29 allocated to IANB. Analgesia success for IANB 100%; BI 67%; p < 0.001. Analgesia success for BI with articaine 71%; lignocaine 64%, p > 0.05. Analgesia success was associated with fewer reports of painful dental treatment, p = 0.005. CONCLUSIONS: There was higher success and less painful treatment with IANB. There was no statistically significant difference in local analgesia success between articaine and lignocaine when delivered via BI.