Efficacy of Articaine over Lidocaine – A Review

The currently available local anesthetic agents are capable of providing high quality nerve blockade in a wide variety of clinical circumstances. Our understanding of the mechanisms and consequences of toxicity is increasing rapidly. Knowledge of the chemistry of local anesthetics has enabled clinicians to exploit the increased safety. Local anesthesia is an important part of the daily routines for a dentist. There are many local anesthesia available of which the most commonly used is lidocaine. The purpose of this paper is to review the use of articaine in dentistry. Literature on use of articaine in comparison to lidocaine is reviewed. Literature review shows articaine is well tolerated and useful local anesthetic agent than lidocaine. Key words: Local Anesthesia, lidocaine, articaine. INTRODUCTION: Pain control in clinical dentistry is mainly achieved using local anaesthetic (LA) drugs. A revolutionary advancement of the late 1800s was the discovery of local anesthetics that facilitated pain prevention without the loss of consciousness. Since that time, a broad spectrum of local anesthetics has been gradually developing. These developments in pain control have enabled the selection and use of local anesthetic drugs based on the individual requirements of patients and the type of procedures. Articaine: Articaine was originally synthesised as articaine in 1969 and entered clinical practice in Germany in 1976 (1). The name was changed in 1984, the year it was released in Canada (2). It then entered the United Kingdom in 1998, (1) the United States in 2000 (3) and Australia in 2005 (4). Currently, articaine is available as a 4% solution containing 1:100, 000 or 1:200, 000 adrenaline. Lidocaine: Upon its clinical availability in 1948, lidocaine hydrochloride became the first marketed amide local anesthetic (2). At that time, it replaced the ester-type local anesthetic procaine (Novocain) as the drug of choice for local anesthetics in dentistry. Lidocaine hydrochloride has maintained its status as the most widely used local anesthetic in dentistry since its introduction. Proven efficacy, low allergenicity, and minimal toxicity through clinical use and research have confirmed the value and safety of this drug. Thus, it became labeled the“gold standard” to which all new local anesthetics are compared (5). Null Hypothesis: 
 The null hypothesis was that no statistically significant difference exists between the anesthetic efficacy of initial administration of two percent lidocaine hydrochloride and four percent articaine hydrochloride, both with epinephrine 1:100,000 in dental applications. Table (1) showing the properties of articaine and lidocaine: M.P. Santhosh Kumar /J. Pharm. Sci. & Res. Vol. 7(11), 2015, 956-959