A comparative clinical study to evaluate the efficacy of lignocaine 2% and articaine 4% for anesthesia of mandibular first molars with irreversible pulpitis

Introduction: Achieving anesthesia in mandibular molars with irreversible pulpitis (IP) is quite challenging. This study highlights the efficacy of two clinically effective local anesthetic agents - lidocaine 2% and articaine 4%. Methodology: Thirty healthy individuals belonging to the American Society of Anesthesiologists 1 with previously diagnosed acute IP of mandibular first molars requiring root canal treatment were randomly assigned to 2 groups of 15 each. Informed consent was obtained, and intradermal allergy test was performed. Group A: patients receiving lidocaine HCl 2% with 1:100,000 adrenaline (Septodont, France) and Group B: patients receiving articaine HCl 4% with 1:100,000 adrenaline (Septodont, France). After adhering to aseptic measures, a conventional inferior alveolar nerve block was administered by palpating the anatomical landmarks, and around 1.8 ml of the anesthetic solution was deposited. Onset of anesthesia, extent of pulpal anesthesia, pain on injection were assessed and statistically analyzed. Results: Onset of action was faster with articaine 4%. There was no significant difference between the EPT scores for both the groups, and pain was of mild intensity. Conclusion: Articaine is an efficient alternative for effective pain management in patients with IP.