Comparison of anesthetic efficacy of 4% articaine and 2% lidocaine for maxillary buccal infiltration in patients with irreversible pulpitis.

OBJECTIVE The purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of 4% articaine and 2% lidocaine (both with 1:100,000 epinephrine) for buccal infiltration in patients experiencing irreversible pulpitis in maxillary posterior teeth. STUDY DESIGN Forty patients with irreversible pulpitis in first premolar or first molar were divided into 4 study groups and received buccal infiltration of either 4% articaine or 2% lidocaine in a double-blind manner. Endodontic access was begun 5 minutes after solution deposition. Success was defined as no or mild discomfort (VAS recordings) during the endodontic procedure. RESULTS The success rate for maxillary buccal infiltration to produce pulpal anesthesia using articaine was 100% in first premolar and first molar, and for the lidocaine solution, success rate was 80% in first premolar and 30% in first molar. There was high significant difference between the articaine and lidocaine solutions (ANOVA; P < .001). CONCLUSION The efficacy of 4% articaine was superior to 2% lidocaine for maxillary buccal infiltration in posterior teeth.