Anesthetic efficacy of 4% articaine versus 2% lignocaine in root canal treatment of teeth with molar incisor hypomineralization.

Context: Inferior alveolar nerve block (IANB) is considered the cornerstone in achieving anesthesia for mandibular molars. However, failure of routine lignocaine IANB to achieve profound anesthesia of the pulp has been reported in patients with molar incisor hypomineralization (MIH). Articaine 4% with epinephrine 1:100,000 has proven to provide total pain relief during most dental procedures.

Aims: This study aimed to assess and compare the pain perception level in children using Visual Analog Scale (VAS) during root canal treatment after administering 4% articaine buccal infiltration (BI), 4% articaine IANB, and 2% lignocaine IANB.

Subjects and methods: Twenty-seven children aged 8-12 years, requiring root canal treatment of mandibular first permanent molars with MIH were randomly allocated into three groups - 4% articaine (1:100,000 epinephrine) BI, 4% articaine (1:100,000 epinephrine) IANB, and 2% lignocaine IANB. The efficacy of the anesthetic was determined by rating the pain perception of the child using a VAS.

Statistical analysis used: The scores marked by the children on the VAS were recorded and were statistically analyzed. Data were entered into Microsoft excel data sheet and were analyzed using SPSS for Windows version 17.0.

Results: Patients anesthetized with 4% articaine IANB presented lesser pain scores compared to IANB with 2% lidocaine and 4% articaine BI on access opening and instrumentation of the root canals.

Conclusion: 4% articaine IANB has better anesthetic efficacy than 4% articaine BI and 2% lignocaine IANB in anesthetising mandibular first permanent molars with MIH.