Abstract
Introduction
The present study comparatively evaluated the anesthetic efficacy of 4% articaine
versus 2% lidocaine given as supplemental intraligamentary injections after a failed
inferior alveolar nerve block.
Methods
One hundred six adult patients with symptomatic irreversible pulpitis in a mandibular
first or second molar received an initial inferior alveolar nerve block with 2% lidocaine
with 1:80,000 epinephrine. Pain during the endodontic treatment was assessed using
the Heft-Parker visual analog scale. Eighty-two patients with unsuccessful anesthesia
were randomly allocated to 2 treatment groups: 1 group received 0.6 mL/root of supplementary
intraligamentary injection of 4% articaine with 1:100,000 epinephrine, and the second
group received 2% lidocaine with 1:80,000 epinephrine. Endodontic treatment was reinitiated.
Success after the primary injection or supplementary injection was defined as no or
mild pain (less than 55 mm on the Heft-Parker visual analog scale) during access preparation
and root canal instrumentation. Patients' heart rate was monitored using a finger
pulse oximeter. The anesthetic success rates were analyzed with the Pearson chi-square
test at 5% significance levels. The heart rate changes were analyzed using the t test.
Results
The patients receiving supplementary intraligamentary injections of 4% articaine had
a success rate of 66%, whereas 2% lidocaine injections were successful in 78% of cases.
The difference was statistically nonsignificant (χ2 = 1.51, P = .2). There was no significant effect of the different anesthetic agents on the
heart rate.
Conclusions
Both 4% articaine and 2% lidocaine improved the success rates after a failed primary
anesthetic injection, with no significant difference between them.
Key Words
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Article info
Publication history
Published online: December 05, 2018
Identification
Copyright
© 2018 American Association of Endodontists.
