Comparative Evaluation of clinical efficacy of 4% Articaine Buccal Infiltration Versus 2% Lignocaine Inferior Alveolar Nerve Block for Pulpal Anaesthesia in Mandibular Molars – A Randomized Clinical Trial.

AbstractBackground: Achieving effective pulpal anaesthesia in mandibular molars is often challenging due to the variable success of the inferior alveolar nerve block (IANB). Although lignocaine is considered the gold standard local anaesthetic, IANB frequently shows failure, particularly in posterior mandibular teeth. Articaine, owing to its superior lipid solubility and bone penetration, has shown promising results when used as buccal infiltration.Aim: To compare the clinical efficacy of two anaesthetic agents inferior alveolar nerve block using 2% lidocaine with 1:80,000 epinephrine & buccal infiltration with 4% articaine with 1:100,000 epinephrine in reducing intraoperative pain during root canal treatment procedures.Materials & methods: Forty two patients indicated for root canal treatment were randomly allocated into two groups (n = 21). Group A received 4% articaine with 1:100,000 epinephrine & Group B received 2% lidocaine with 1: 80,000 epinephrine. Intraoperative pain was assessed using a Visual Analogue Scale (VAS) before & during the procedure of access opening and biomechanical preparation. Data were statistically analyzed using repeated measures ANOVA followed by post-hoc Tukey test.Results: A total of 42 patients were included in the study, with 21 patients in each group. Preoperative pain scores assessed using the Heft Parker Visual Analog Scale (HPVAS) showed no statistically significant difference between the two groups, indicating comparable baseline pain levels. Intraoperatively, the articaine buccal infiltration group demonstrated significantly lower pain scores compared to the lignocaine inferior alveolar nerve block group. A higher success rate of pulpal anaesthesia and reduced need for supplemental anaesthesia were observed in the articaine group, suggesting superior anaesthetic efficacy of 4% articaine buccal infiltration over2% lignocaine IANB in mandibular first molars.Conclusion: Buccal infiltration with 4% articaine demonstrated superior clinical efficacy in achieving pulpal anaesthesia in mandibular molars compared to 2% lignocaine administered via inferior alveolar nerve block. Articaine infiltration may therefore be considered a reliable and effective alternative to conventional nerve block techniques in endodontic practice.