Efficacy of 4% articaine vs 2% lidocaine in mandibular and maxillary block and infiltration anaesthesia in patients with irreversible pulpitis: a systematic review and meta-analysis

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Introduction

Methods

Protocol development

Search strategy

Inclusion criteria outline according to the PICOS strategy

Exclusion criteria

  • Studies involving patients with a significant medical history or on medicaments that may affect the anaesthetic assessment.

  • Observational study designs, case reports, case series, cross-sectional studies, and reviews.

  • Trials reporting a single intervention.

  • Article reporting only abstracts and full-texts were not available in the database.

Screening process

Data extraction

Assessments of the risk of bias and quality

Statistical analysis

Results

Literature search

Study characteristics

Assessments of the level of evidence, risk of bias, and quality

Synthesis of results

The success rate of anaesthesia for mandibular teeth

The success rate of anaesthesia for maxillary teeth

Sensitivity analysis

Discussion

Conclusions

KEY HIGHLIGHTS of the current analysis

  1. Successful pulpal anaesthesia is the cornerstone for painless root canal treatment, especially in patients with symptomatic pulpitis.

  2. Articaine was introduced to overcome supplemental anaesthesia and to increase the effectiveness of the quality of anaesthesia.

  3. Articaine is associated with a lower visual analogue scale rating for pain.

  4. Articaine resulted in 1.37-fold and 1.06-fold higher clinical success rate than lidocaine for mandibular and maxillary teeth respectively.

Supplemental Information

PRISMA checklist

DOI: 10.7717/peerj.12214/supp-1

Systematic Review and Meta-Analysis Rationale and contribution of the article

DOI: 10.7717/peerj.12214/supp-2

Additional Information and Declarations

Competing Interests

The authors declare there are no competing interests.

Author Contributions

Sanjay Miglani conceived and designed the experiments, performed the experiments, analyzed the data, prepared figures and/or tables, and approved the final draft.

Irfan Ansari conceived and designed the experiments, analyzed the data, prepared figures and/or tables, and approved the final draft.

Swadheena Patro and Ankita Mohanty performed the experiments, prepared figures and/or tables, and approved the final draft.

Shahnaz Mansoori and Bhoomika Ahuja performed the experiments, analyzed the data, prepared figures and/or tables, and approved the final draft.

Mohmed Isaqali Karobari conceived and designed the experiments, analyzed the data, authored or reviewed drafts of the paper, and approved the final draft.

Krishna Prasad Shetty, Musab Hamed Saeed and Alexander Maniangat Luke analyzed the data, authored or reviewed drafts of the paper, and approved the final draft.

Ajinkya M. Pawar conceived and designed the experiments, performed the experiments, authored or reviewed drafts of the paper, and approved the final draft.

Data Availability

The following information was supplied regarding data availability:

This is a review article. There is no raw data.

Funding

The authors received no funding for this work.

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