Should clinicians use infiltration anaesthesia rather than the inferior dental block technique when treating adult patients for safety, effectiveness, and comfort?

Abstract

Objectives To evaluate buccal infiltration (BI) with any anaesthetic, and the inferior dental block (IDB) with 2% lidocaine, and compare their safety, efficacy, and patients' perception of pain during administration. Method A systematic search and critical appraisal were completed resulting in five studies, four randomised controlled trials and one systematic review and meta-analysis. Patient safety was measured by adverse effects, efficacy was measured without supplementary anaesthesia, and comfort was measured by patients' perception of pain during administration. Results All studies compared the efficacy of BI using 4% articaine versus 2% lidocaine IDB. One study reported a statistical significance of BI compared to IDB (p = 0.03), with a success rate of only 40%. Two studies investigated adverse effects, with zero recorded. No studies discussed the pain reported by patients during administration. Conclusion Four percent articaine BI can be used as an alternative to 2% lidocaine IDB. Further research is required on pain during administration and adverse effects as there is limited evidence.