Comparison of articaine 4% and lidocaine 2% in paediatric dental patients

Objective. To evaluate and compare the reaction of children who received local anaesthesia with lidocaine 2% with 1:100 000 epinephrine and articaine 4% with 1:200 000 epinephrine and to assess the time of the onset, efficacy, duration of numbness of the soft tissues, children's sensation after treatment to both anaesthetic solutions, as well as the occurrence of adverse events. Samples and methods. Sixty-two children (34 girls and 28 boys) aged 5-13 years (mean age 8·4 ± 2·3) from two established paediatric dental clinics who needed similar operative procedures preceded by local anaesthesia were randomly assigned to receive either lidocaine or articaine at their first or second visit. Modified Taddio's behavioural pain scale was used to evaluate pain reaction during injection and treatment. The sensation after injection and treatment was evaluated using the Wong-Baker FACES pain rating scale. Parents recorded the time when the feeling of local anaesthesia in soft tissues disappeared. Results. Duration of numbness of soft tissues was significantly longer for articaine (3·43 ± 0·7 h) than for lidocaine (3·0 ± 0·8 h) (P = 0·003). No difference regarding the efficacy of the anaesthesia was observed. Reaction to pain was similar for both local anaesthetic solutions and no significant difference was found between genders. The efficacy of the anaesthesia was similar for both solutions. The feeling after treatment was similar for both solutions. The rate of adverse effects was similar for the two solutions. Conclusions. Articaine 4% with 1:200 000 epinephrine is as effective as lidocaine 2% with 1:100 000 epinephrine. The effect of numbness of soft tissues was longer lasting with articaine than with lidocaine.