Comparative study of articaine and lidocaine for third molar surgery
Abstract
Background: 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. Materials and Methods: 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). Results: 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. Conclusion: 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.
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2. Contar CM, de Oliveira P, Kanegusuku K, Berticelli RD, Azevedo-Alanis LR, Machado MA. Complications in third molar removal: a retrospective study of 588 patients. Med Oral Patol Oral Cir Bucal. 2010;15:74–8.
3. Brauer HA. Unusual complications associated with third molar surgery: a systematic review. Quintessence Int . 2009;40:565–72.
4. Rakhshan V. Common risk factors for postoperative pain following the extraction of wisdom teeth. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2015;41(2):59-65.
5. Seymour RA, Blair GS, Wyatt FA. Post-operative dental pain and analgesic efficacy. Br J Oral Surg. 1983;21:290–7.
6. Berini-Aytés L, Gay-Escoda C. Anestesia Odontológica. 2nd ed. Madrid: Ediciones Avances Medico-Dentales, S.L.; 2000.
7. Malamed SF. HandBook of Local Anesthesia. 4th ed. St Louis: CV Mosby; 1997.
8. Mehra P, Caiazzo A, Maloney P. Lidocaine toxicity. Anesth Prog 1998;45:38-41.
9. Daublander M, Muller R, Lipp MD. The incidence of complications as- sociated with local anesthesia in dentistry. Anesth Prog 1997;44:132-41.
10. Malamed SF, Gagnon S, Leblanc D. Efficacy of articaine: a new amide local anesthetic. J Am Dent Assoc 2000;131:635-42.
11. Cowan A. Clinical assessment of a new local anesthetic agent: carti- caine. Oral Surg Oral Med Oral Pathol 1977;43:174-80.
12. Silva LC, Thiago-de-S S, Santos JA, Maia MC, Mendonça CG. Articaine versus lidocaine for third molar surgery: a randomized clinical study. Medicina oral, patologia oral y cirugia bucal. 2012 Jan;17(1):e140.
13. Saggu MK, Aga H, Saggu JS, Burke GA. Local anaesthesia using Articaine and Lidocaine in oral and dental surgery: A comparative meta-analysis. Open Journal of Stomatology. 2014 Feb 6;4(02):84.
14. Kambalimath DH, Dolas RS, Kambalimath HV, Agrawal SM. Efficacy of 4% Articaine and 2% Lidocaine: A clinical study. Journal of maxillofacial and oral surgery. 2013 Mar 1;12(1):3-10.
15. Sreekumar K, Bhargava D. A prospective randomized double-blind study to assess the latency and efficacy of articaine and lignocaine in surgical removal of impacted mandibular third molars in Indian patients. international journal of stomatology & occlusion medicine. 2012 Mar 1;5(1):10-4.
16. Sierra Rebolledo A, Delgado Molina E, Berini Aytés L, Gay Escoda C. Comparative study of the anesthetic efficacy of 4% articaine versus 2% lidocaine in inferior alveolar nerve block during surgical extraction of impacted lower third molars. Medicina Oral, Patología Oral y Cirugía Bucal (Internet). 2007 Mar;12(2):139-44.
17. Shruthi R, Kedarnath NS, Mamatha NS, Rajaram P, BhadraShetty D. Articaine for surgical removal of impacted third molar; a comparison with lignocaine. Journal of international oral health: JIOH. 2013 Feb;5(1):48.
18. Haas DA, Harper DG, Saso MA, Young ER. Comparison of articaine and prilocaine anesthesia by infiltration in maxillary and mandibular arches. Anesth Prog 1990;37:230-7.
19. Vahatalo K, Antila H, Lehtinen R. Articaine and lidocaine for maxillary infiltration anesthesia. Anesth Prog 1993;40:114-6.
20. Malamed SF, Gagnon S, Leblanc D. A comparison between articaine HCl and lidocaine HCl in pediatric dental patients. Pediatr Dent 2000;22:307-11.
21. Malamed SF, Gagnon S, Leblanc D. Articaine hydrochloride: a study of the safety of a new amide local anesthetic. J Am Dent Assoc 2001;132:177-85.
22. Earl P. Patient’s anxieties with third molar surgery. Br J Oral Maxillofac Surg 1994; 32(5): 2937.
23. Hupp J, Tucker M, Ellis E. Postoperative Patient Management. Contemporary Oral and Maxillofacial Surgery. 6th ed. St. Louis, Missouri : Elsevier; 2014. p.168-9
24. Joshi A, Snowdon A, Rood J, Worthington H. Pain control after routine dento-alveolar day surgery: a patient satisfaction survey. British dental journal. 2000 Oct 28;189(8):439.
25. Sigron GR, Pourmand PP, Mache B, Stadlinger B, Locher MC. The most common complications after wisdom-tooth removal: part 1: a retrospective study of 1,199 cases in the mandible. Swiss Dent J. 2014;124(10):1042-6
26. Eshghpour M, Nejat AH. Dry socket following surgical removal of impacted third molar in an Iranian population: Incidence and risk factors. Nigerian journal of clinical practice. 2013;16(4).
27. Momeni H, Shahnaseri S, Hamzeheil Z. Evaluation of relative distribution and risk factors in patients with dry socket referring to Yazd dental clinics. Dental Research Journal. 2011;8(Suppl1):S84-S87.
28. Tarakji B, Saleh LA, Umair A, Azzeghaiby SN, Hanouneh S. Systemic review of dry socket: aetiology, treatment, and prevention. Journal of clinical and diagnostic research: JCDR. 2015 Apr;9(4):ZE10.
29. Noroozi AR, Philbert RF. Modern concepts in understanding and management of the “dry socket” syndrome: comprehensive review of the literature. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2009 Jan 31;107(1):30-5.
30. Blum IR. Contemporary views on dry socket (alveolar osteitis): a clinical appraisal of standardization, aetiopathogenesis and management: a critical review. Int J Oral Maxillofac Surg 2002;31:309-17
31.Fisher SE, Frame JW, Rout PG, McEntegart DJ. Factors affecting the onset and severity of pain following the surgical removal of unilateral impacted mandibular third molar teeth. Br Dent J 1988; 164(11): 3514.
32. Woolf CJ, Salter MW. Neuronal plasticity: Incresing the gain in pain. Science 2000; 288(5472): 1765.
33. Katyal V. The efficacy and safety of articaine versus lignocaine in dental treatments: a meta-analysis. journal of dentistry. 2010 Apr 30;38(4):307-17
34. Haas DA, Lennon D. Local anesthetic use by dentists in Ontario. Journal (Canadian Dental Association). 1995 Apr;61(4):297-304.
35. Pogrel MA. Permanent nerve damage from inferior alveolar nerve blocks-an update to include articaine. CDA. 2007 Apr;35(4):271.
36. Khoury F, Hinterthan A, Schürmann J, Arns H. Clinical comparative study of local anesthetics. Random double blind study with four commercial preparations. Deutsche Zahnarztliche Zeitschrift. 1991 Dec;46(12):822-4.
37. Martínez-Rodríguez N, Barona-Dorado C, Martín-Arés M, Cortés-Bretón-Brinkman J, Martínez-González JM. Evaluation of the anaesthetic properties and tolerance of 1: 100,000 articaine versus 1: 100,000 lidocaine. A comparative study in surgery of the lower third molar. Medicina oral, patologia oral y cirugia bucal. 2012 Mar;17(2):e345.
38. Yaghiela JA, Dowd FJ, Johnson B. Local anesthetics. In: Pharmacology & Therapeutics for Dentistry-E Book, 6th ed., Mosby: Elsevier; 2010.p. 255.
2. Contar CM, de Oliveira P, Kanegusuku K, Berticelli RD, Azevedo-Alanis LR, Machado MA. Complications in third molar removal: a retrospective study of 588 patients. Med Oral Patol Oral Cir Bucal. 2010;15:74–8.
3. Brauer HA. Unusual complications associated with third molar surgery: a systematic review. Quintessence Int . 2009;40:565–72.
4. Rakhshan V. Common risk factors for postoperative pain following the extraction of wisdom teeth. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2015;41(2):59-65.
5. Seymour RA, Blair GS, Wyatt FA. Post-operative dental pain and analgesic efficacy. Br J Oral Surg. 1983;21:290–7.
6. Berini-Aytés L, Gay-Escoda C. Anestesia Odontológica. 2nd ed. Madrid: Ediciones Avances Medico-Dentales, S.L.; 2000.
7. Malamed SF. HandBook of Local Anesthesia. 4th ed. St Louis: CV Mosby; 1997.
8. Mehra P, Caiazzo A, Maloney P. Lidocaine toxicity. Anesth Prog 1998;45:38-41.
9. Daublander M, Muller R, Lipp MD. The incidence of complications as- sociated with local anesthesia in dentistry. Anesth Prog 1997;44:132-41.
10. Malamed SF, Gagnon S, Leblanc D. Efficacy of articaine: a new amide local anesthetic. J Am Dent Assoc 2000;131:635-42.
11. Cowan A. Clinical assessment of a new local anesthetic agent: carti- caine. Oral Surg Oral Med Oral Pathol 1977;43:174-80.
12. Silva LC, Thiago-de-S S, Santos JA, Maia MC, Mendonça CG. Articaine versus lidocaine for third molar surgery: a randomized clinical study. Medicina oral, patologia oral y cirugia bucal. 2012 Jan;17(1):e140.
13. Saggu MK, Aga H, Saggu JS, Burke GA. Local anaesthesia using Articaine and Lidocaine in oral and dental surgery: A comparative meta-analysis. Open Journal of Stomatology. 2014 Feb 6;4(02):84.
14. Kambalimath DH, Dolas RS, Kambalimath HV, Agrawal SM. Efficacy of 4% Articaine and 2% Lidocaine: A clinical study. Journal of maxillofacial and oral surgery. 2013 Mar 1;12(1):3-10.
15. Sreekumar K, Bhargava D. A prospective randomized double-blind study to assess the latency and efficacy of articaine and lignocaine in surgical removal of impacted mandibular third molars in Indian patients. international journal of stomatology & occlusion medicine. 2012 Mar 1;5(1):10-4.
16. Sierra Rebolledo A, Delgado Molina E, Berini Aytés L, Gay Escoda C. Comparative study of the anesthetic efficacy of 4% articaine versus 2% lidocaine in inferior alveolar nerve block during surgical extraction of impacted lower third molars. Medicina Oral, Patología Oral y Cirugía Bucal (Internet). 2007 Mar;12(2):139-44.
17. Shruthi R, Kedarnath NS, Mamatha NS, Rajaram P, BhadraShetty D. Articaine for surgical removal of impacted third molar; a comparison with lignocaine. Journal of international oral health: JIOH. 2013 Feb;5(1):48.
18. Haas DA, Harper DG, Saso MA, Young ER. Comparison of articaine and prilocaine anesthesia by infiltration in maxillary and mandibular arches. Anesth Prog 1990;37:230-7.
19. Vahatalo K, Antila H, Lehtinen R. Articaine and lidocaine for maxillary infiltration anesthesia. Anesth Prog 1993;40:114-6.
20. Malamed SF, Gagnon S, Leblanc D. A comparison between articaine HCl and lidocaine HCl in pediatric dental patients. Pediatr Dent 2000;22:307-11.
21. Malamed SF, Gagnon S, Leblanc D. Articaine hydrochloride: a study of the safety of a new amide local anesthetic. J Am Dent Assoc 2001;132:177-85.
22. Earl P. Patient’s anxieties with third molar surgery. Br J Oral Maxillofac Surg 1994; 32(5): 2937.
23. Hupp J, Tucker M, Ellis E. Postoperative Patient Management. Contemporary Oral and Maxillofacial Surgery. 6th ed. St. Louis, Missouri : Elsevier; 2014. p.168-9
24. Joshi A, Snowdon A, Rood J, Worthington H. Pain control after routine dento-alveolar day surgery: a patient satisfaction survey. British dental journal. 2000 Oct 28;189(8):439.
25. Sigron GR, Pourmand PP, Mache B, Stadlinger B, Locher MC. The most common complications after wisdom-tooth removal: part 1: a retrospective study of 1,199 cases in the mandible. Swiss Dent J. 2014;124(10):1042-6
26. Eshghpour M, Nejat AH. Dry socket following surgical removal of impacted third molar in an Iranian population: Incidence and risk factors. Nigerian journal of clinical practice. 2013;16(4).
27. Momeni H, Shahnaseri S, Hamzeheil Z. Evaluation of relative distribution and risk factors in patients with dry socket referring to Yazd dental clinics. Dental Research Journal. 2011;8(Suppl1):S84-S87.
28. Tarakji B, Saleh LA, Umair A, Azzeghaiby SN, Hanouneh S. Systemic review of dry socket: aetiology, treatment, and prevention. Journal of clinical and diagnostic research: JCDR. 2015 Apr;9(4):ZE10.
29. Noroozi AR, Philbert RF. Modern concepts in understanding and management of the “dry socket” syndrome: comprehensive review of the literature. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2009 Jan 31;107(1):30-5.
30. Blum IR. Contemporary views on dry socket (alveolar osteitis): a clinical appraisal of standardization, aetiopathogenesis and management: a critical review. Int J Oral Maxillofac Surg 2002;31:309-17
31.Fisher SE, Frame JW, Rout PG, McEntegart DJ. Factors affecting the onset and severity of pain following the surgical removal of unilateral impacted mandibular third molar teeth. Br Dent J 1988; 164(11): 3514.
32. Woolf CJ, Salter MW. Neuronal plasticity: Incresing the gain in pain. Science 2000; 288(5472): 1765.
33. Katyal V. The efficacy and safety of articaine versus lignocaine in dental treatments: a meta-analysis. journal of dentistry. 2010 Apr 30;38(4):307-17
34. Haas DA, Lennon D. Local anesthetic use by dentists in Ontario. Journal (Canadian Dental Association). 1995 Apr;61(4):297-304.
35. Pogrel MA. Permanent nerve damage from inferior alveolar nerve blocks-an update to include articaine. CDA. 2007 Apr;35(4):271.
36. Khoury F, Hinterthan A, Schürmann J, Arns H. Clinical comparative study of local anesthetics. Random double blind study with four commercial preparations. Deutsche Zahnarztliche Zeitschrift. 1991 Dec;46(12):822-4.
37. Martínez-Rodríguez N, Barona-Dorado C, Martín-Arés M, Cortés-Bretón-Brinkman J, Martínez-González JM. Evaluation of the anaesthetic properties and tolerance of 1: 100,000 articaine versus 1: 100,000 lidocaine. A comparative study in surgery of the lower third molar. Medicina oral, patologia oral y cirugia bucal. 2012 Mar;17(2):e345.
38. Yaghiela JA, Dowd FJ, Johnson B. Local anesthetics. In: Pharmacology & Therapeutics for Dentistry-E Book, 6th ed., Mosby: Elsevier; 2010.p. 255.
| Files | ||
| Issue | Vol 6, No 1 (Winter 2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jcr.v6i1.1627 | |
| Keywords | ||
| Articaine Bleeding Dry socket IAN bock Impacted lower third molar Lidocaine Post operative pain | ||
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How to Cite
1.
Shahnaseri S, Mohammadi N, Tamizifar A, Mousavi SA. Comparative study of articaine and lidocaine for third molar surgery. J Craniomaxillofac Res. 2019;6(1):26-33.
