Can buccal infiltration of articaine replace traditional inferior alveolar nerve block for the treatment of mandibular molars in pediatric patients?: A systematic review and meta-analysis

Med Oral Patol Oral Cir Bucal. 2021 Nov 1;26(6):e754-e761. doi: 10.4317/medoral.24726.

Abstract

Background: It is unclear if buccal articaine infiltration can be used as an alternative to standard inferior alveolar nerve block (IANB) for treating mandibular molars in pediatric patients. Therefore, this study aimed to pool evidence to compare the efficacy of buccal infiltration of articaine vs IANB with lignocaine for pediatric dental procedures.

Material and methods: We searched the PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases for randomized controlled trials (RCTs) comparing the two techniques in pediatric patients and reporting the success of anesthesia and/or pain during treatment. PRISMA guidelines were followed.

Results: Seven RCTs were included. Pooled analysis of five studies indicated no statistically significant difference in the success rates of the two anesthetic techniques (OR: 1.02; 95% CI: 0.13, 7.96; I2=69%, p=0.98). Meta-analysis of data from the four studies demonstrated no statistically significant difference in pain during the procedure with buccal infiltration of articaine or IANB with lignocaine (SMD: 0.62; 95% CI: -1.37, 0.12; I2=88%, p=0.10).

Conclusions: Evidence suggests that buccal infiltration of articaine is a viable alternative to IANB with lignocaine in pediatric patients for treating mandibular molars. Based on the confidence intervals, there may be a tendency of higher success rates with buccal infiltration of articaine.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Anesthesia, Dental*
  • Anesthetics, Local
  • Carticaine
  • Child
  • Double-Blind Method
  • Humans
  • Lidocaine
  • Mandibular Nerve
  • Molar
  • Nerve Block*
  • Pulpitis* / surgery

Substances

  • Anesthetics, Local
  • Lidocaine
  • Carticaine