TITLE:
Local anaesthesia using Articaine and Lidocaine in oral and dental surgery: A comparative meta-analysis
AUTHORS:
M. K. Saggu, H. Aga, J. S. Saggu, G. A. E. Burke
KEYWORDS:
Lidocaine; Articaine; Meta-Analysis
JOURNAL NAME:
Open Journal of Stomatology,
Vol.4 No.2,
February
26,
2014
ABSTRACT: Background: Articaine is an
amide local anaesthetic, which is gaining popularity for use in dental and oral
surgical anaesthesia in the United Kingdom. Hitherto there has been
insufficient evidence to recommend articaine above the more commonly used
lidocaine for dental procedures. The aim of this study is to compare the
efficacy of 4% articaine with 1:100,000 adrenaline (4AA) with that of 2%
lidocaine with 1:100,000 adrenaline (2LA) administered as buccal infiltrations
for anaesthesia in mandibular permanent first molar teeth. Any significant advantage
noted may obviate the need for regional blockage of the inferior dental nerve
in dental or minor oral surgical procedure under local anaesthesia. Objectives:
To review the published literature comparing the efficacies of 4AA and 2LA
for achieving pulpal anaesthesia in human mandibular permanent first molar
teeth. Null Hypothesis: 4AA and 2LA are of equal efficacy when used to
anaesthetize mandibular permanent first molar teeth by buccal infiltration. Method:
An electronic search encompassing Ovid MEDLINE?, PubMed (National Center for
Biotechnology Information, US National Library of Medicine), SCOPUS?, SCIRUS?,
EMBASE? databases and the Cochrane Library was performed to identify trials
relating to the efficacy of 4AA and 2LA local anaesthetic solutions on mandibular
first molars in adult participants. Study characteristics and outcome data were
extracted as a basis for meta-analysis. Results: Three randomised controlled
trials were identified for this meta-analysis. The relative efficacy of 4AA over
2LA in anesthetizing permanent first mandibular molars was calculated at 1.57
(95% CI = 1.27 to 1.95). Conclusion: Despite the promising results shown in the
meta-analysis it is difficult to say from the evidence presented that 4AA
should be used clinically in preference over 2LA.