The ability to provide pain- free dentistry is important and the American Dental Association Center for Evidence-Based Dentistry (ADA-EBD)has just published this critical summary of a 2011 systematic review by Brandt et al . The review compares the efffecacy of two local anaesthetics ( 4% articaine and 2% lidocaine) in providing successful pulpal anaesthesia. The review has also been the subject of a commentary in the journal of Evidence-based Dental Practice by Balto ( 2011).
The ADA-EBD summariser considered that the search strategy was well conducted by there were methodological queries they consider could have overstated the results. Overall the number of participants included was small but the study results were consistent in showing that 4% articaine is more likely to provide successful anaesthesia than is 2 % lidocaine for routine dental procedures.
The commentary by Balto gave the review a B Grade strength of Recommendation.
The Dental Elf has covered a number of trials over the past 12 months that have also looked at the effectiveness of articaine.
ADA-EBD Summary -Articaine is superior to lidocaine in providing pulpal anesthesia
Balto K. Administration of articaine anesthesia may lead to superior profound pulpal anesthesia compared with lidocaine in adult patients. J Evid Based Dent Pract. 2011 Dec;11(4):183-4. PubMed PMID: 22078827.
Brandt RG, Anderson PF, McDonald NJ, Sohn W, Peters MC. The pulpal anesthetic efficacy of articaine versus lidocaine in dentistry: a meta-analysis. J Am Dent Assoc. 2011 May;142(5):493-504. PubMed PMID: 21531931.