Efficacy of articaine vs lignocaine in maxillary and mandibular infiltration and block anesthesia in the dental treatments of adults: A systematic review and meta-analysis.

Abstract

The aim of the present systematic review and meta-analysis was to address the following Population, Intervention, Comparison, and Outcome question: Is the efficacy of articaine better than lignocaine in adults requiring dental treatment? Four percent articaine was compared with 2% lignocaine for maxillary and mandibular infiltrations and block anesthesia, and with the principal outcome measures of anesthetic success. Using RevMan software, the weighted anesthesia success rates and 95% confidence intervals (CIs) were estimated and compared using a random-effects model. For combined studies, articaine was more likely to achieve successful anesthesia than lignocaine (N=18, odds ratio [OR]: 1.92, 95% CI: 1.45-2.56, P<0.00001, I2 =32%). Maxillary and mandibular infiltration studies showed obvious superiority of articaine to lignocaine (N=8, OR: 2.50, 95% CI: 1.51-4.15, P=0.0004, I2 =41%). Maxillary infiltration subgroup analysis showed no significant difference between articaine and lignocaine (N=5, OR: 1.69, 95% CI: 0.88-3.23, P=0.11, I2 =19%). For combined mandibular anesthesia studies, articaine was superior to lignocaine (N=14, OR: 1.99, 95% CI: 1.45-2.72, P<0.0001, I2 =32%), with further subgroup analysis showing significant differences in both mandibular block anesthesia (N=11, OR: 1.55, 95% CI: 1.19-2.03, P=0.001), I2 =0%) and mandibular infiltration (N=3, OR: 3.87, 95% CI: 2.62-5.72, P<0.00001, I2 =0%), indicating that articaine is more effective than lignocaine in providing anesthetic success in routine dental procedures.