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

PeerJ

article

Sanjay Miglani¹  Irfan Ansari¹  Swadheena Patro²  Ankita Mohanty²  Shahnaz Mansoori³  Bhoomika Ahuja⁴  Mohmed Isaqali Karobari⁵  Krishna Prasad Shetty⁷  Musab Hamed Saeed⁷  Alexander Maniangat Luke⁷  Ajinkya M. Pawar⁹ 

[1] Department of Conservative Dentistry & Endodontics, Faculty of Dentistry, Jamia Millia Islamia ,(A Central University);Department of Conservative Dentistry & Endodontics, Kalinga Institute of Dental Sciences;Department of Public Health, Faculty of Dentistry, Jamia Millia Islamia ,(A Central University);Department of Paediatric Dentistry, K D Dental College;Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus;Department of Conservative Dentistry & Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University;Department of Clinical Science, College of Dentistry, Ajman University;Centre of Medical and Bio-allied Health Sciences Research, Ajman University;Department of Conservative Dentistry & Endodontics, Nair Hospital Dental College

关键词: Articaine;    Irreversible pulpitis;    Lidocaine;    Meta-analysis;    Sensitivity analysis;    Success rate;   

DOI  :  10.7717/peerj.12214

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

ObjectiveThe goal of this systematic review and meta-analysis is to determine the performance of 4% Articaine vs. 2% Lidocaine for mandibular and maxillary block and infiltration anaesthesia in patients with irreversible pulpitis (IP).MethodsPubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Google Scholar, and Open Gray were used to conduct a thorough literature search. A manual search of the reference lists of the publications found was also carried out. Two reviewers critically evaluated the papers for inclusion and exclusion criteria, and data extraction was done on the selected publications. The Cochrane Collaboration Tool and the Minors checklist were used to assess the quality of the selected studies for randomised controlled trials (RCTs) and non-randomised studies, respectively. The RevMan software was used to perform a meta-analysis of the pooled data and subgroups according to the technique of anaesthetic solution delivery, as well as a sensitivity analysis (P < 0.05).ResultsA total of twenty-six papers were included in the qualitative synthesis, with twenty-two of them being included in the meta-analysis. There were fifteen studies with a low potential for bias, three with a moderate potential for bias, and seven with a high potential for bias. The combined results of the 19 trials in the tooth level unit revealed that 4% articaine had a success rate 1.37 times greater than 2% lidocaine for mandibular teeth (RR, 1.37; 95% CI [1.17–1.62]; P = 0.0002). For the maxillary buccal infiltration method, the combined results from the three trials revealed that 4% articaine resulted in a success rate 1.06 times greater than 2% lidocaine (RR, 1.06; 95% CI [0.95–1.2]; P = 0.3). Excluding subgroups with a single study in sensitivity analysis for mandibular teeth revealed a substantial improvement in the success rate of the articaine group in treating IP when compared to the lidocaine group.ConclusionThe findings of this meta-analysis back up the claim that articaine is more effective than lidocaine in providing anaesthesia in patients with IP. PROSPERO Registration No.: CRD42020204606 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020204606).

【 授权许可】

CC BY