Comparative study of articaine and lidocaine for third molar surgery

This study aims to compare the anesthetic efficacy, postoperative pain, hemorrhage & dry sock incidence of articaine 4% versus lidocaine 2% in inferior alveolar nerve block during impacted lower third molar surgery.

A prospective randomized study was conducted on 20 subjects planned for elective surgical removal of bilateral impacted mandibular with similar difficulty indices. A single operator performed all surgeries on basis using 4% articaine or 2% lidocaine as an anesthetic agent and with the same concentration of vasoconstrictor (epinephrine 1:100,1000). Latency, duration of anesthetic effect, intra and post surgical pain experiences, hemorrhage & dry socket occurrences were evaluated with respect to the type of anesthetia. A visual analog scale was used to score pain. Data were analyzed by descriptive statistics, repeated measures ANOVA, Wilcoxon and McNemar’s test (α=0.05).

Latency, Intra & Postoperative pain and hemorrhage showed clinical differences in favor of articaine, though statistical significance was not reached. In turn, the mean duration of anesthetic for articain was much extended and showed statistically significant difference. Dry socket incidence consisted of two occurrences (5%) and those two only occurred in Lidocain group.

Although 4% articaine offers better pharmacological performance than 2% lidocaine, both articaine and lidocaine have demonstrated adequate, negligible differences and acceptable clinical profiles. For this reason, their use in oral surgery should remain of the professional preference who will evaluate their use base on the necessary surgical time.