Anesthetic efficiency of articaine versus lidocaine in the extraction of lower third molar: A meta-analysis and systematic review

Publication date: Available online 5 September 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Aobo Zhang, Huasong Tang, Shaopeng Liu, Chuan Ma, Shixing Ma, Huaqiang Zhao

Abstract:

Purpose

The purpose of this study was to evaluate whether the anesthetic efficiency of articaine is superior to lidocaine during the extraction of lower third molar (LTME).

Method

Pubmed, Cochrane, Web of science three electronic databases were searched to identify randomized controlled trials (RCTs) up to December, 31 2017. Five evaluation indexes were extracted, namely success rate of anesthesia (SRA), subjective and objective onset time of anesthesia (SOA, OOA), duration time of anesthesia (DTA) and intra-operative pain assessment (IPA) to assess the anesthesia efficiency of these two solutions. All data analyses were conducted by using Review Manager 5.3.

Results

Nine studies were included in this review, the sample was composed of 770 lower third molar extractions from 493 patients, of which 382 patients were in the lidocaine group and 388 in the articaine group. Compared with lidocaine, the 4% articaine with 1:100 000 epinephrine showed higher SRA (risk ratio(RR), 1.10; 95% confidence intervals (CI),1.01 to 1.21; P=0.03), shorter SOA (SMD, 1.20; 95%CI, 0.50 to 1.89; P=0.0007), longer DTA (MD, 0.83h; 95%CI, 0.59 to 1.07; P<0.00001); but for IPA (MD, 3.12mm; 95%CI, -0.13 to 6.37; P=0.06) and OOA (SMD, 0.44; 95%CI, -0.39 to 1.26; P=0.30), there was no significant difference between the two solutions.

Conclusion

The results of this study suggest that 4% articaine with 1:100 000 epinephrine possesses superior anesthetic efficiency relative to lidocaine for IANB during LTME.

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