Anaesthetic efficacy of 4% articaine and 2% lidocaine for extraction and pulpotomy of mandibular primary molars: an equivalence parallel prospective randomized controlled trial

Abstract

Aim: To compare the anaesthetic efficacy for pain and behaviour during treatment with mandibular infiltration using 4% articaine (BI) with inferior dental nerve clock (IDNB) using 2% lidocaine for extraction or pulp therapy in mandibular primary molars. Design: This was equivalence parallel prospective RCT. A total of 98 children aged 5–9 years old were randomly assigned into two groups: BI supplemented by buccal intrapapillary infiltration with 4% articaine; IDNB with 2% lidocaine supplemented with long buccal infiltration. Behaviour during the injection and treatment procedures was assessed using Wong-Baker Facial Rating Scale (W-BFRS), Visual Analogue Scale (VAS), and Frankl Behaviour Rating Scale (FBRS). Results: During the injection phase, the absolute differences in success rates between the two techniques were 0.06 (95% CI: −0.11 to 0.23) for VAS and −0.08 (95% CI: −0.19 to 0.03) for the behaviour of the child (FBRS). FBRS results showed the equivalence of the two, whereas the VAS results showed nonequivalence with the 95% confidence intervals slightly exceeding the equivalence margin (±0.20). W-BFRS success rates were 63.3% for both. During the treatment, VAS results showed similar success rates, demonstrating equivalence between the two as did the results for FBRS. Conclusion: The results suggested equivalence in success rates for both anaesthetic techniques during treatment.