Comparison of Articaine Infiltration to Lidocaine via Inferior Alveolar Nerve Block in Pediatric Patients

Purpose: To evaluate and compare the effectiveness of articaine local infiltration to lidocaine inferior alveolar nerve block (IANB) for restorative treatment of deciduous mandibular molars (DMM). Methods: In this double-blind randomized controlled clinical trial with parallel design, participants were enrolled according to specified inclusion criteria (4-10 years of age, need of DMM restorative treatment, Frankel 4 behavior) and randomly assigned into either articaine or lidocaine group. One investigator administrated all local anesthesia (LA). Nineteen trained and calibrated examiners blinded to LA type, evaluated participants’ reactions during LA administration and treatment using Modified Behavioral Pain Scale (MBPS). Participants rated their experiences using Wong-Baker FACES Pain Rating Scale (WBFS). Subjects’ blood pressure and pulse were recorded throughout procedures. Statistical analysis employed independent t-tests, Mann Whitney-U, Repeated Measures ANOVA (P<0.05) and Cohen's kappa. Results: A total of 110 (n=55 per group) participants (6.42 years mean age; 60 percent males) were enrolled. The average MBPS rating during LA administration was higher for lidocaine IANB (3.89) compared to articaine infiltration (2.24; P=.000). The average MBPS rating throughout treatment was also higher for the lidocaine group (2.51) compared to articaine group (1.69; P=.012). The lidocaine group had a mean of 1.64 for WBFS, while articaine group had a WBFS score of 0.872 (P=.089). All physiological measurements were within normal limits with no difference between groups. Conclusions: This study demonstrated that local infiltration with articaine was less painful upon administration and may be considered a safe and effective alternative to lidocaine IANB for restorative treatment in DMM.