Efficacy of 4% articaine with 1:100000 epinephrine versus 2% lignocaine with 1:100000 epinephrine in infiltration for extraction of maxillary premolars for orthodontic correction – A prospective, randomized, double-blind, crossover study

Abstract

Background: Unlike other amide local anesthetics (LAs), articaine has better lipid solubility and potency. Very few studies have been done on comparing articaine with other LAs as buccal infiltration among the participants requiring paired extraction of maxillary premolars but limitations of those studies include smaller sample size, lack of washout periods, and diversity in study designs. Aims and Objectives: This study compares the anesthetic efficacy of 4% articaine (1:100,000 epinephrine) with 2% lidocaine (1:100,000 epinephrine) as buccal infiltration. Materials and Methods: This is a randomized double-blinded crossover study conducted at the Department of Oral and Maxillofacial Surgery in collaboration with the Department of Pharmacology, SRIHER, Chennai. This study was done on 59 participants on an outpatient basis. The selected participants received 4% articaine or lignocaine with epinephrine (1:100000) in the mucobuccal fold at the maxillary area during their first visit and the same individual received the other local anesthetic drug on the other side in the same area during the second visit, i.e., 1 week from the date of the first visit. All the statistics were calculated using the software Statistical Package for the Social Sciences 16 version. For all primary and secondary outcomes in the study, the Mann–Whitney U-test was employed to compute the mean and standard deviation. Results: The total mean age of the participants included was 21.69. The volume of drug required was 1.578 ± 0.2760 mL for articaine and 2.2068 ± 0.0984 ml for lignocaine. The onset time was 30–45 s with articaine and 75–90 s with lignocaine. A decrease in pain scores was seen in the articaine group compared to the lignocaine group. Conclusion: This study showed better efficacy of articaine in comparison to lignocaine. Articaine may replace lignocaine in orthodontic corrections with its higher efficacy, faster action, and longer duration.