EFFICACY AND INTRA-OPERATIVE PAIN CONTROL OF LIDOCAINE AND ARTICAINE IN SURGICAL REMOVAL OF IMPACTED LOWER THIRD MOLAR
Khalil, Mohammed A. El-Shall & Hesham S. . 2007
The choice of local anesthetic solution in the oral surgical procedures should be based on the ideal properties of the solution which afford safety to patients. Important criteria of an ideal local anesthetic solution include its potency, latency, duration, distribution, metabolization and excretion. Aim of the work: The present study compares the local anesthetic efficacy and post operative pain control of 4% articaine versus 2% lidocaine, both with epinephrine 1:100,000, in inferior alveolar nerve block during the surgical removal of impacted lower third molars, College of Dentistry, King Saud University, Saudi Arabia. Materials and Methods: Two Oral and Maxillofacial surgeons at the College of Dentistry, King Saud University, conducted a double-blind randomized clinical trial of 30 patients (24 males and 6 females) planned for bilateral surgical removal of the lower third molars. After injection of the anesthetic solution, the time of onset, duration of action and fade out of local anesthesia were recorded. The need for further injections, local hemostasis at the surgical site and perioperative complications were also noted. A visual analog scale from 0 to 10 centimeters was also used to subjectively assess the pain during surgery. Results: A total of 60 surgical removals of impacted lower third molars were carried out. The subjective intra-operative pain scoring by the patients using pain visual analogue scale (VAS) showed no differences between the two anesthetic solutions (P= 0.85), with mean VAS scores of 0.83 mm (SD: 0.69) and 0.8 mm (SD: 0.64) for lidocaine and articaine, respectively. Although the two anesthetic solutions have the same concentration of adrenaline, hemostasis was seen well in case of articaine. Conclusion: Although articaine was superior in its anesthetic features such as its rapid onset and long duration of action, it has been noticed that both articaine and lidocaine are good in controlling pain during surgical extraction of lower third molars. Therefore, the choice of articaine or lidocaine should be based on the accumulative reported complications resulted from these drugs which favors the use of lidocaine.
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