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Efficacy and safety of articaine versus lidocaine for irreversible pulpitis treatment: A systematic review and meta‐analysis of randomised controlled trials
Author(s) -
Su Naichuan,
Li Chunjie,
Wang Hang,
Shen Jiefei,
Liu Wenjia,
Kou Liang
Publication year - 2016
Publication title -
australian endodontic journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.703
H-Index - 34
eISSN - 1747-4477
pISSN - 1329-1947
DOI - 10.1111/aej.12125
Subject(s) - articaine , medicine , lidocaine , epinephrine , pulpitis , relative risk , anesthesia , adverse effect , confidence interval , randomized controlled trial , meta analysis , clinical trial , dentistry , pulp (tooth)
The aim was to assess the efficacy and safety of articaine compared with lidocaine for irreversible pulpitis ( IP ) treatment. Databases were explored electronically and relevant journals as well as the references of the included studies were hand‐searched for randomised clinical trials comparing the efficacy and safety of articaine with lidocaine in treatment of IP . Twenty studies were included, of which eight had low risk of bias, 10 had moderate risk of bias and two had high risk of bias. In comparison with 2% lidocaine with 1:100 000 epinephrine, 4% articaine with 1:100 000 epinephrine showed a higher success rate in anaesthesia of IP at either person (risk ratio ( RR ) 1.15; 95% confidence intervals ( CI ) 1.10 1.20; P < 0.00001) or tooth unit ( RR 1.10; 95% CI 1.10 1.19, P < 0.00001), lower VAS scores during injection phase (mean difference ( MD ) −0.67; 95% CI −1.26 −0.08, P = 0.02) and treatment phase ( MD −3.35; 95% CI −3.78 −2.91, P < 0.00001), shorter onset time of pulpal anaesthesia ( MD −0.94; 95% CI −1.13 −0.74, P < 0.00001) and lower percentage of patients undergoing adverse events ( RR 0.17; 95% CI 0.03 0.92, P = 0.04). Given the efficacy and safety of the two solutions, 4% articaine with 1:100 000 epinephrine was superior to 2% lidocaine with 1:100 000 epinephrine in dental treatments in IP .