Onset and duration of 2% lidocaine as inferior alveolar nerve block versus buccal/lingual infiltration of 4% articaine in mandibular second molars: Clinical trial study

BACKGROUND and AIM: The effectiveness of buccal or lingual (B/L) infiltration of 4% articaine as supplemental injection for pulp anesthesia of mandibular teeth was confirmed in previous studies. However, this study was aimed to compare the effectiveness of 2% lidocaine as inferior alveolar nerve block (IANB) versus B/L infiltration of 4% articaine for pulp anesthesia, as primary injection in mandibular second molars. METHODS: Thirty adult volunteers ranging from 18 to 40 years old with no systemic disease or medicine intake were included in this split-mouth, double-blind, randomized clinical trial study. Each mandibular side of included subjects was allocated randomly to control group (IANB using 2% lidocaine and 1/80000 epinephrine using direct technique) and B/L infiltration group using 4% articaine (Septanest; Septodont, Saint-Maur-des-Fosses, France). After obtaining base line sensitivity, electric pulp testing (EPT) was done at 5, 8, 11, 15, 20, 25, 30, 45, 60, 75, and 90 minutes post injections. The data were analyzed using chi-square test. RESULTS: The success rate of anesthesia for IANB group was 83.3% (25 of 30 subjects) and 30% (9 of 30 subjects) for B/L infiltration group, and the difference between the groups was statistically significant (P=0.0005). The mean onset time of pulp anesthesia for IANB group was 22.6 ± 30.9 minutes and 65.5 ± 38.0 for B/L infiltration group, and the difference between the groups was statistically significant (P = 0.0001). The mean duration time of pulp anesthesia for IANB group was 53.0 ± 27.4 minutes and 10.6±17.2 for B/L infiltration group, and the difference between the groups was statistically significant (P=0.0001). CONCLUSION: The results indicated that IANB using 2% lidocaine was more successful than B/L infiltration of 4% articaine in onset and duration of pulp anesthesia of mandibular second molars as primary injections.