Abstract
ABSTRACT Background The authors evaluated published evidence from controlled clinical trials regarding the efficacy of two local anesthetic solutions in providing successful pulpal anesthesia. Methods The authors searched MEDLINE and Embase databases to identify peer-reviewed randomized controlled trials in which researchers directly compared articaine and lidocaine local anesthetic solutions in adult participants. They extracted study characteristics and outcomes data as a basis for meta-analysis. They completed subgroup analyses for both infiltration and mandibular inferior alveolar block anesthetic techniques. Results Articaine solutions had a probability of achieving anesthetic success superior to that of lidocaine, with an odds ratio of 2.44 (95 percent confidence interval [CI], 1.59–3.76; P P P = .009), and no difference when the authors considered only symptomatic teeth. Clinical Implications Research evidence supports using articaine versus lidocaine for achieving pulpal anesthesia when the infiltration mode of administration is used. It is premature to recommend articaine for mandibular block anesthesia in cases involving irreversible pulpitis.
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