Anaesthetic efficacy of 4% articaine and 2% lidocaine for extraction and pulpotomy of mandibular primary molars: an equivalence parallel prospective randomized controlled trial

Int J Paediatr Dent. 2018 May;28(3):335-344. doi: 10.1111/ipd.12361. Epub 2018 Mar 24.


Aim: To compare the anaesthetic efficacy for pain and behaviour during treatment with mandibular infiltration using 4% articaine (BI) with inferior dental nerve clock (IDNB) using 2% lidocaine for extraction or pulp therapy in mandibular primary molars.

Design: This was equivalence parallel prospective RCT. A total of 98 children aged 5-9 years old were randomly assigned into two groups: BI supplemented by buccal intrapapillary infiltration with 4% articaine; IDNB with 2% lidocaine supplemented with long buccal infiltration. Behaviour during the injection and treatment procedures was assessed using Wong-Baker Facial Rating Scale (W-BFRS), Visual Analogue Scale (VAS), and Frankl Behaviour Rating Scale (FBRS).

Results: During the injection phase, the absolute differences in success rates between the two techniques were 0.06 (95% CI: -0.11 to 0.23) for VAS and -0.08 (95% CI: -0.19 to 0.03) for the behaviour of the child (FBRS). FBRS results showed the equivalence of the two, whereas the VAS results showed nonequivalence with the 95% confidence intervals slightly exceeding the equivalence margin (±0.20). W-BFRS success rates were 63.3% for both. During the treatment, VAS results showed similar success rates, demonstrating equivalence between the two as did the results for FBRS.

Conclusion: The results suggested equivalence in success rates for both anaesthetic techniques during treatment.

Publication types

  • Comparative Study
  • Equivalence Trial
  • Randomized Controlled Trial

MeSH terms

  • Anesthesia, Dental*
  • Anesthesia, Local
  • Anesthetics, Local / administration & dosage*
  • Carticaine / administration & dosage*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Injections
  • Lidocaine / administration & dosage*
  • Male
  • Nerve Block
  • Pain / prevention & control*
  • Pain Measurement
  • Prospective Studies
  • Pulpotomy*
  • Tooth Extraction*
  • Tooth, Deciduous


  • Anesthetics, Local
  • Lidocaine
  • Carticaine