Articaine Local Infiltration Vs Lidocaine IANB for Restoration of First Permanent Molars in Children

Purpose: To compare the effectiveness and subjective pain perception of Articaine infiltration local anesthesia versus Lidocaine inferior alveolar nerve block for restoration of mandibular first permanent molars. Methods: Forty participants (from 7 to 12 years of age) were equally and randomly allocated into either the Articaine or the Lidocaine group. One investigator completed all local anesthesia administrations. Subjects' reactions during anesthesia administration and throughout dental treatment were assessed by trained and calibrated examiners and recorded according to a validated Modified Behavioral Pain Scale. Physiologic evaluations of pain were collected by measuring subjects’ pulse and blood pressure throughout the procedure. Subjects' pain perception was assessed using the Wong-Baker FACES Pain Response Scale. The data was categorized and analyzed. Bivariate statistics included independent t-test and Mann Whitney-U. Results: Articaine and Lidocaine had similar clinical success and lack of post-operative complications. Subjective measurement of pain was lower for Articaine both during injection (p=0.02) and treatment (p=0.03). There was no statistical difference between groups for physiologic measurements. Median self-reported pain was twice as high for Lidocaine (4 vs 2). Conclusion: Articaine local infiltration was associated with less pain on administration and during treatment and is as effective as Lidocaine inferior alveolar nerve block for restoration of mandibular first permanent molars in pediatric patients.