Anesthetic Efficacy of Articaine Versus Lidocaine for Irreversible Pulpitis: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

XIAO Jiaoling ^1,2 , LI Yali ^1,3 ,  MA Bin ¹ , PENG Hui ³ , SHI Qiongling ² , YU Zhanhai ²

1. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China;2. College of Stomatology of Lanzhou University, Lanzhou 730000,China;3. The Second Clinical Medical College of Lanzhou University, Lanzhou 730000,China;

Corresponding author：

MA Bin, Email: kitty_mab@163.com

Keywords：

Irreversible pulpitis; Articaine; Lidocaine; Meta-analysis

DOI：

10.7507/1672-2531.20100545

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Objective 　To assess the anesthetic efficacy of articaine versus lidocaine for irreversible pulpitis.
Methods 　We electronically searched PubMed, EMbase, Cochrane Library (Issue 4, 2009), CNKI, VIP and CBM. The search was updated to December 2009. Randomized controlled trials (RCTs) and quasi-RCTs were indentified about articaine and lidocaine for irreversible pulpitis. Study selection and meta-analysis were conducted according to the Cochrane Handbook for systematic reviews. And RevMan5.0 was applied for statistical analysis in success rate.
Results 　Nine trials involving 985 pulpitis patients were included. Meta-analysis indicated that, both the anesthetic success rate (RR=1.33, 95%CI 1.23 to1.44) and maxillary anesthetic success rate (RR=1.65, 95%CI 1.38 to 1.98) of articaine were superior to that of lidocaine, but there was no statistical significance in mandibular anesthetic success rate between two groups (RR=1.28, 95%CI 0.97 to 1.69).
Conclusion 　The current evidence shows that articaine is superior to lidocaine in anesthetic efficacy, and is good at maxillary anesthesia.

Citation： XIAO Jiaoling,LI Yali,MA Bin,PENG Hui,SHI Qiongling,YU Zhanhai. Anesthetic Efficacy of Articaine Versus Lidocaine for Irreversible Pulpitis: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2010, 10(9): 1058-1062. doi: 10.7507/1672-2531.20100545 Copy

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2.	Claffey E, Reader A, Nusstein J, et al. Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis. J Endod, 2004, 30(8): 568-571.
3.	Corbett IP, Ramacciato JC, Groppo FC, et al. A survey of local anaesthetic use among general dental practitioners in the U.K. attending post-graduate courses on pain control. Br Dent J, 2005, 199(12): 784-787.
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5.	Reisman D, Reader A, Nist R, et al. Anesthetic efficacy of the supplemental intraosseous injection of 3% mepivacaine in irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1997, 84(6): 676-682.
6.	Cohen HP, Cha BY, Spangberg LS. Endodontic anesthesia in mandibular molars: a clinical study. J Endod, 1993, 19(7): 370-373.
7.	Kennedy S, Reader A, Nusstein J, et al. The significance of needle deflection in success of the inferior alveolar nerve block in patientswith irreversible pulpitis. J Endodon, 2003, 29(10): 630-633.
8.	Gouws P, Galloway P, Jacob J, et al. Comparison of articaine and bupivacaine/lidocaine for sub-Tenon’s anaesthesia in cataract extraction. Br J Anaesth, 2004, 92(2): 228-230.
9.	Malamed SF, Gagnon S, Leblanc D. Efficacy of articaine: a new amidelocal anesthetic. J Am Dent Assoc, 2000, 131(5): 635-642.
10.	Srinivasan N, Kavitha M, Chandarasekaran S, et al. Comparison of anesthetic efficacy of 4% articaine and 2%lidocaine for maxillary buccal infiltration in patients with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 107(1): 133-136.
11.	Tortamano IP, Siviero M, Costa CG, et al. A Comparison of the Anesthetic Efficacy of Articaine and Lidocaine in Patients with Irreversible Pulpitis. J Endod, 2009, 35(2): 165-168.
12.	王兰翠, 郑军, 张凤英. 必兰在牙髓炎治疗中的应用效果分析. 现代医药卫生, 2009, 25(6): 850.
13.	谢桂英. 局麻药在治疗老年人急性牙髓炎中的应用观察. 实用医技杂志, 2008, 15(24): 1371-1372.
14.	胥欣, 冀洪海, 杨勇, 等. 碧兰麻在牙科治疗中的应用与疗效. 中国现代药物应用, 2008, 2(17): 11-12.
15.	张丽, 林雪峰, 陈刚, 等. 碧兰麻用于口腔局部麻醉的临床疗效观察. 中国校医, 2005, 19(3): 308-309.
16.	廖明华. 碧兰麻在牙髓失活中的麻醉效果观察. 右江民族医学院学报, 2004, 4: 504-505.
17.	梁登忠, 胡玉兰, 关淑妮, 等. 碧兰麻在牙髓治疗中麻醉效果观察. 广西医科大学学报, 2001, 18 (4): 529-530.
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20.	Malamed SF, Gagnon S, Leblanc D. Articaine hydrochloride: a study of the safety of a new amide local anesthetic. J Am Dent Assoc, 2001, 132(2): 177-185.
21.	Isen DA. Articaine: pharmacology and clinical use of a recently approved local anesthetic. Dent Today, 2000, 19(11): 72-77.
22.	Van Oss GE, Vree TB, Baars AM. et al. Pharmacokinetics, metabolism, and renal excretion of articaine and its metabolite articainic acid in patients after epidural administration. Eur J Anaesthesiol, 1989, 6(1): 49-56.
23.	Oertel R, Rahn R, Kirch W. Clinical pharmacokinetics of articaine. Clin Pharmacokinet, 1997, 33(6): 417-425.
24.	Heft MW, Parker SR. An experimental basis for revising the graphic rating scale for pain. Pain, 1984, 19(2): 153-161.

1. 樊明文. 牙体牙髓病学. 第2版. 北京: 人民卫生出版社, 2003: 198.
2. Claffey E, Reader A, Nusstein J, et al. Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis. J Endod, 2004, 30(8): 568-571.
3. Corbett IP, Ramacciato JC, Groppo FC, et al. A survey of local anaesthetic use among general dental practitioners in the U.K. attending post-graduate courses on pain control. Br Dent J, 2005, 199(12): 784-787.
4. Nusstein J, Reader A, Nist R, et al. Anesthetic efficacy of the supplemental intraosseous injection of 2% lidocaine with 1:100,000 epinephrine in irreversible pulpitis. J Endod, 1998, 24(7): 487-491.
5. Reisman D, Reader A, Nist R, et al. Anesthetic efficacy of the supplemental intraosseous injection of 3% mepivacaine in irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1997, 84(6): 676-682.
6. Cohen HP, Cha BY, Spangberg LS. Endodontic anesthesia in mandibular molars: a clinical study. J Endod, 1993, 19(7): 370-373.
7. Kennedy S, Reader A, Nusstein J, et al. The significance of needle deflection in success of the inferior alveolar nerve block in patientswith irreversible pulpitis. J Endodon, 2003, 29(10): 630-633.
8. Gouws P, Galloway P, Jacob J, et al. Comparison of articaine and bupivacaine/lidocaine for sub-Tenon’s anaesthesia in cataract extraction. Br J Anaesth, 2004, 92(2): 228-230.
9. Malamed SF, Gagnon S, Leblanc D. Efficacy of articaine: a new amidelocal anesthetic. J Am Dent Assoc, 2000, 131(5): 635-642.
10. Srinivasan N, Kavitha M, Chandarasekaran S, et al. Comparison of anesthetic efficacy of 4% articaine and 2%lidocaine for maxillary buccal infiltration in patients with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 107(1): 133-136.
11. Tortamano IP, Siviero M, Costa CG, et al. A Comparison of the Anesthetic Efficacy of Articaine and Lidocaine in Patients with Irreversible Pulpitis. J Endod, 2009, 35(2): 165-168.
12. 王兰翠, 郑军, 张凤英. 必兰在牙髓炎治疗中的应用效果分析. 现代医药卫生, 2009, 25(6): 850.
13. 谢桂英. 局麻药在治疗老年人急性牙髓炎中的应用观察. 实用医技杂志, 2008, 15(24): 1371-1372.
14. 胥欣, 冀洪海, 杨勇, 等. 碧兰麻在牙科治疗中的应用与疗效. 中国现代药物应用, 2008, 2(17): 11-12.
15. 张丽, 林雪峰, 陈刚, 等. 碧兰麻用于口腔局部麻醉的临床疗效观察. 中国校医, 2005, 19(3): 308-309.
16. 廖明华. 碧兰麻在牙髓失活中的麻醉效果观察. 右江民族医学院学报, 2004, 4: 504-505.
17. 梁登忠, 胡玉兰, 关淑妮, 等. 碧兰麻在牙髓治疗中麻醉效果观察. 广西医科大学学报, 2001, 18 (4): 529-530.
18. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. [www.cochrane-handbook.org/]. Accessed 10 March 2009.
19. 曾光明. 口腔临床药物学. 第1版. 北京: 人民卫生出版社, 2003: 53.
20. Malamed SF, Gagnon S, Leblanc D. Articaine hydrochloride: a study of the safety of a new amide local anesthetic. J Am Dent Assoc, 2001, 132(2): 177-185.
21. Isen DA. Articaine: pharmacology and clinical use of a recently approved local anesthetic. Dent Today, 2000, 19(11): 72-77.
22. Van Oss GE, Vree TB, Baars AM. et al. Pharmacokinetics, metabolism, and renal excretion of articaine and its metabolite articainic acid in patients after epidural administration. Eur J Anaesthesiol, 1989, 6(1): 49-56.
23. Oertel R, Rahn R, Kirch W. Clinical pharmacokinetics of articaine. Clin Pharmacokinet, 1997, 33(6): 417-425.
24. Heft MW, Parker SR. An experimental basis for revising the graphic rating scale for pain. Pain, 1984, 19(2): 153-161.

Chinese Journal of Evidence-Based Medicine

Anesthetic Efficacy of Articaine Versus Lidocaine for Irreversible Pulpitis: A Meta-analysis

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