Comparison of Local Anesthetic Effects of Lidocaine and Articaine at Different Buccal Cortical Bone Thicknesses during Mandibular Molar Implant Surgery

Objective: This study aims to evaluate the efficacy of local infiltration anesthesia using lidocaine and articaine during mandibular molar implant surgery with different buccal cortical bone thicknesses (1 mm, 1–2 mm, 2 mm), to provide scientific evidence for the clinical selection of anesthetic agents. Methods: The study subjects were 240 adult patients who underwent mandibular molar implant surgery at the Second Affiliated Hospital of Hainan Medical University between May 2023 and May 2024. The thickness of the buccal cortical bone was confirmed using cone-beam computed tomography (CBCT), and patients were randomly divided into three groups: the first group (cortical bone thickness 1 mm), study group (lidocaine, 40 patients) and control group (articaine, 40 patients); the second group (cortical bone thickness 1–2 mm), study group (lidocaine, 40 patients) and control group (articaine, 40 patients); and the third group (cortical bone thickness 2 mm), study group (lidocaine, 40 patients) and control group (articaine, 40 patients). The primary outcomes measured were onset time of anesthesia (seconds) and anesthesia efficacy rate (percentage). Results: In the first group, the onset time of anesthesia in the lidocaine group and articaine group was 45.2 ± 5.32 seconds and 44.80 ± 4.60 seconds, respectively, with no statistically significant difference (p = 0.720). The overall efficacy rates were 95.0% and 97.5%, respectively, with no significant difference (p = 0.556). In the second group, the onset time of anesthesia was significantly longer in the lidocaine group than in the articaine group (56.70 ± 6.05 seconds vs. 50.35 ± 5.66 seconds, p < 0.05), and the overall efficacy rate was lower (80.0% vs. 95.0%, p < 0.05). In the third group, the onset time of anesthesia was significantly prolonged in the lidocaine group (65.4 ± 6.68 seconds) compared to the articaine group (52.25 ± 5.80 seconds, p < 0.01), and the overall efficacy rate was significantly lower in the lidocaine group (79.0% vs. 90.0%, p < 0.01). Conclusion: There is no significant difference in anesthetic efficacy between lidocaine and articaine when the buccal cortical bone thickness is 1 mm. However, when the buccal cortical bone thickness is 1–2 mm or 2 mm, articaine demonstrates a faster onset time and higher anesthetic efficacy.