A Clinical Comparative Study of Two Local Dental Anesthetics: Articaine and Mepivacaine
Articaine is a new amide local anesthetic in Thai land. This study sought to compare the safety and efficacy of 4% articaine with epinephrine 1:100,000 and 2 mepivacaine with epinephrine 1:100,000, which is the most used local anesthetic in dentistry In two identical randomized double-blinded trials: the single-rooted tooth extraction procedure and the single-root canal treatment procedure, subjects 10 to 44 years of age received either 4 articaine with opinephrine 1:100,000 or 2% mepivacaine with epinephrine 1:100,000. In cach trial, we randomized the subjects to receive articaine or mepivacaine Efficacy was determined by subjects using a visual analog scale or VAS. We used a non-parametric analy- sis to analyze the data. In a total of 68 subjects, we found that there was no significant difference in demographics among four groups in the two trials. The time of onset (or onset time) in each procedure was comparable for both articaine and mepivacaine We showed no statistical difference hetween two local anesthetic groups in each trial with respect to subject pain rating, using the VAS (P>0.05; Kruskal- Wallis test). Our findings suggest that 4% articaine provided clinically effective pain relief during the tooth extraction and the root canal therapy. The time onset of articaine is appropriate for clinical use and comparable to those observed for other commercially available local anesthetics.
1. Vree TB, Vree JB, Baars AM, Nouws JF, Hekster YA: Hydroxylation and oxidation of nalidixic acid in the turtle Pseudemys scripta elegans. Ver Q 1988; 10: 67-9.
2. Raab WH, Muller R, Muller HF: [Comparative investigations of anesthetic activity of 2- and 4% Articain]. Quintessenz 1990; 41: 1207-16.
3. Haas DA, Harper DG, Saso MA, Young ER: Com- parison of articaine and prilocaine anesthesia by infiltration in maxillary and mandibular arches. Anesth Prog 1990; 37: 230-7.
4. Malamed SF, Gagnon S, Leblanc D: A comparison between articaine HCl and lidocaine HCl in pedi- atric dental patients. Pediatr Dent 2000; 22:307- 11.
5. Lemay H, Albert G, Helie P. Dufour L, Gagnon P, Payant L, Laliberte R: [Ultracaine in conventional operative dentistry). J Can Dent Assoc 1984; 50: 703-8.
6. Cowan A: Clinical assessment of a new local an- esthetic agent-carticaine. Oral Surg Oral Med Oral Pathol 1977; 43: 174-80.
7. Haas DA, Harper DG, Saso MA, Young ER: Lack of differential effect by Ultracaine (articaine) and Citanest (prilocaine) in infiltration anaesthesia. J Can Dent Assoc 1991: 57: 217-23.
8. Winther JE, Nathalang B: Effectivity of a new local analgesic Hoe 40 045. Scand J Dent Res 1972: 80: 272-8.
9. Winther JE, Patirupanusara B: Evaluation of carticaine a new local analgesic. Int J Oral Surg 1974: 3:422-7.
10. Ruprecht S. Knoll-Kohler E: [A comparative study of equimolar solutions of lidocaine and articaine for anesthesia. A randomized double-blind cross- over study]. Schweiz Monatsschr Zahnmed 1991; 101: 1286-90.
11. Rahn R, Hauzeneder W. Flanze L: [Efficiency of a 2% epinephrine-free Articain solution (Ultracain 2%) for dental local anesthesia). Dtsch Stomatol 1991: 41:379-82.
12. Malamed SF, Gagnon S. Leblanc D: Efficacy of articaine: a new amide local anesthetic. J Am Dent Assoc 2000; 131: 635-42.
13. Malamed SF, Gagnon S, Leblanc D: Articaine hydrochloride: a study of the safety of a new amide local anesthetic. J Am Dent Assoc 2001; 132: 177- 85.