A comparison between articaine mandibular infiltration and lidocaine mandibular block anesthesia in second primary molar: A randomized clinical trial

Abstract

Background: One of the most important objectives of pediatric dentistry during dental practice
is pain control and effective anesthesia. Because of the limitations of inferior alveolar nerve
block (IANB), other techniques such as infiltration injection are suggested. Infiltration technique by
using some other solutions such as articaine is an appropriate alteration for mandibular anesthesia.
The aim of this study is to compare the efficacy of IANB using lidocaine with infiltration injection
by articaine in mandibular second primary molar anesthesia in 8–11‑year‑old children.
Materials and Methods: This is a randomized, cross‑over, clinical trial that was performed on
42 children aged 8–11 years, who needed extraction of both mandibular second primary molars.
After clinical and radiographic investigations, block or infiltration injection was chosen randomly
and treatment was performed in one side in each session. Patient’s behavior was registered in two
steps of injection and extraction by SEM scores. For comparison of the two sides, Wilcoxon–signed
rank test was used (P < 0.05).
Results: We concluded that infiltration technique resulted in decrease of all the three SEM scores
in comparison to block injection (P < 0.05). The effectiveness of two techniques during tooth
extraction, although grade of lidocaine block was more than infiltrate, was not statistically significant.
Conclusion: It seems that infiltration technique with articaine is a better substitute for block
technique in the extraction of mandibular primary molars.
Key Words: Articaine, lidocaine, local anesthesia