327 - Comparison of Articaine Infiltration to Lidocaine IANB in Pediatric Patients

Comparison of Articaine Infiltration to Lidocaine IANB in Pediatric Patients

Garcia JO, Zhang IL, Shah A, Marion IW, Han MD, da Fonseca MA, Kratunova EH, (University of Illinois at Chicago, Chicago, IL)

Purpose: To 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 treatment, Frankel 4 behavior) and randomly assigned to either the articaine or lidocaine group. One investigator administrated all local anesthesia (LA). Fifteen 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 experience using Wong-Baker FACES Pain Rating Scale (WBFS). Subjects’ blood pressure and pulse were recorded throughout procedure. Statistical analysis included independent t-tests, Mann Whitney-U, and Repeated Measures ANOVA (P < 0.05). Cohen's kappa score was used for examiner reliability.

Results: A total of 110 participants (n=55 per group) were enrolled. The average MBPS rating was significantly higher for lidocaine IANB (3.89) compared to articaine infiltration (2.23; P=.000). The average MBPS rating throughout treatment was also significantly higher for the lidocaine group (2.51) compared to the articaine group (1.69; P=.012). The lidocaine group had a mean of 1.63 for WBFS, while the articaine group had a WBFS score of 1.21 (P=.089). All physiological measurements were within normal limits and with no difference between groups.

Conclusions: The study demonstrated that local infiltration with articaine was less painful upon administration and provided a safe and effective alternative to lidocaine IANB for providing restorative treatment of DMM.